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Journal of Affective Disorders
Journal Prestige (SJR): 2.053
Citation Impact (citeScore): 4
Number of Followers: 17  
 
  Hybrid Journal Hybrid journal (It can contain Open Access articles)
ISSN (Print) 0165-0327
Published by Elsevier Homepage  [3159 journals]
  • Preliminary support for the role of reward relevant effort and chronotype
           in the depression/insomnia comorbidity
    • Abstract: Publication date: Available online 15 August 2018Source: Journal of Affective DisordersAuthor(s): Elaine M. Boland, Kassondra Bertulis, Shirley Chen, Michael E. Thase, Philip R. GehrmanAbstractBackground: The presence of insomnia in the context of depression is linked to a number of poor outcomes including reduced treatment response, increased likelihood of relapse, and greater functional impairment. Given the frequent co-occurrence of depression and insomnia, research into systems and processes relevant to both disorders, specifically reward processing and circadian rhythm disruption, may help parse this complex comorbidity.MethodsA pilot study was conducted on a sample of 10 veterans with clinically significant depression and insomnia symptoms. Participants completed objective (actigraphy) and subjective (sleep diary) assessments of sleep, self-reports of chronotype, and behavioral tasks assessing reward relevant effort before and after 6 sessions of Cognitive Behavioral Therapy for Insomnia.Results: Insomnia and depression significantly improved following CBT-I. Subjective sleep parameters significantly improved with large effect sizes. Actigraphy results were nonsignificant, but effect sizes for sleep efficiency and onset latency were in the medium range. Chronotype shifted significantly toward morningness following CBT-I, and an earlier chronotype at baseline was associated with increased reward effort following treatment. Changes in chronotype, depression and insomnia were not associated with changes in effort.Limitations: Findings are limited by small sample size and lack of randomized control group.Conclusions: Findings should be interpreted as hypothesis generating in the service of furthering research aimed at uncovering potential mechanisms underlying the depression/insomnia comorbidity. Analyses of sleep data in extant datasets of reward processing impairments in depression as well as original projects aimed at exploring potential sleep, circadian rhythm, and reward interactions in depression are encouraged.
       
  • Depressive mood and circadian rhythms disturbances as outcomes of seasonal
           affective disorder treatment: A systematic review
    • Abstract: Publication date: Available online 15 August 2018Source: Journal of Affective DisordersAuthor(s): Giulia Menculini, Norma Verdolini, Andrea Murru, Isabella Pacchiarotti, Umberto Volpe, Antonella Cervino, Luca Steardo, Patrizia Moretti, Eduard Vieta, Alfonso TortorellaAbstractBackgroundThe present systematic review was aimed at critically summarizing the evidence about interventions focused on circadian rhythms and mood symptoms in seasonal affective disorder (SAD).MethodsA systematic search of the electronic databases PUBMED, PsycINFO and Web of Science was conducted according to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) statement. Original papers reporting data about the effects of treatments on both mood and circadian rhythms disturbances in SAD patients were considered for inclusion. The quality of the evidence provided by the eligible studies was assessed using the Revised Cochrane Risk of Bias Tool (RoB 2.0) and the Cochrane Risk of Bias in Non-Randomized Studies of Interventions Tool (ROBINS-I).ResultsForty papers were deemed eligible for the systematic review. The evidence of treatment outcomes referring to circadian disturbances was not robust. Despite this, bright light therapy (BLT) demonstrates to phase-advance delayed rhythms and to improve sleep-wake disorders. As for mood symptoms, both BLT and selective serotonin reuptake inhibitors (SSRIs) show evidence of efficacy. The possible connection between improvements of mood symptoms and changes in circadian outcomes seems controversial.LimitationsThe included studies presented considerable methodological heterogeneity, small sample sizes and non-optimal sample selection.ConclusionsThe effectiveness of BLT in depressive symptoms and circadian disturbances of SAD was outlined by the present systematic review. The evidence about other biological and pharmacological treatments, although promising, should be replicated. A multifactorial etiopathogenesis could explain the heterogeneous clinical presentations of SAD and the complex link between mood and circadian symptoms.
       
  • The association between socio-economic status and depression among older
           adults in Finland, Poland and Spain: a comparative cross-sectional study
           of distinct measures and pathways
    • Abstract: Publication date: Available online 15 August 2018Source: Journal of Affective DisordersAuthor(s): Joan Domènech-Abella, Jordi Mundó, Matilde Leonardi, Sommath Chatterji, Beata Tobiasz-Adamczyk, Seppo Koskinen, Jose Luis Ayuso-Mateos, Josep Maria HaroAbstractBackgroundSocioeconomic status, as measured by education, occupation or income, is associated with depression. However, data are lacking on the psychosocial, material and behavioral mediators of these associations. We have examined the association of education, occupation and income with depression and the potential mediations using community-based data.MethodsA total of 7,966 older adults were interviewed in Finland, Poland and Spain. The differential associations between depression and SES, mediator variables, country of residence and cofounder variables, such as chronic physical conditions, were assessed through logistic regression models. Meditation analyses were carried out using khb method for Stata 13.1.ResultsEducation, followed by household income, were the SES indicators most frequently significantly associated with depression. These SES markers, but not occupation, showed an independent effect in this association. Psychosocial factors and loneliness in particular showed the strongest associations with depression among mediator variables. However, material factors and, especially, financial strain had a higher mediating function in the association between SES and depression. Overall, SES markers, chronic conditions and mediation factors were more positive in Finland than in Poland and Spain.ConclusionImproving psychosocial and material dimensions as well as access to the educational system for older adults might result in a reduction in the prevalence of depression in the general population and particularly among individuals with low SES.
       
  • The association between gestational diabetes mellitus and postpartum
           depressive symptomatology: a prospective cohort study
    • Abstract: Publication date: Available online 15 August 2018Source: Journal of Affective DisordersAuthor(s): Aleksi Ruohomäki, Elena Toffol, Subina Upadhyaya, Leea Keski-Nisula, Juha Pekkanen, Jussi Lampi, Sari Voutilainen, Tomi-Pekka Tuomainen, Seppo Heinonen, Kirsti Kumpulainen, Markku Pasanen, Soili M. LehtoAbstractBackground: The literature suggests an association between type 2 diabetes mellitus and depression, but data on the association between gestational diabetes mellitus (GDM) and postpartum depressive symptomatology (PPDS) are scarce.Methods: Altogether, 1066 women with no previous mental health issues enrolled in the Kuopio Birth Cohort (KuBiCo, www.kubico.fi) were selected for this study. GDM was diagnosed according to the Finnish Current Care Guidelines. Depressive symptomatology was assessed with the Edinburgh Postnatal Depression Scale (EPDS) during the third trimester of pregnancy and eight weeks after delivery. Additionally, a subgroup of women (n = 505) also completed the EPDS during the first trimester of pregnancy.Results: The prevalence rates of GDM and PPDS in the whole study population were 14.1% and 10.3%, respectively. GDM was associated with an increased likelihood of belonging to the PPDS group (OR 2.23, 95% CI 1.23–4.05; adjusted for maternal age at delivery, BMI in the first trimester, smoking before pregnancy, relationship status, nulliparity, delivery by caesarean section, gestational age at delivery, neonatal intensive care unit admission and third-trimester EPDS scores). A significant association between GDM and PPDS was found in the subgroup of women with available data on first-trimester depression (n = 505).Limitations: The participation rate of the KuBiCo study was relatively low (37%).Conclusions: Women with GDM may be at increased risk of PPDS. Future studies should investigate whether these women would benefit from a closer follow-up and possible supportive interventions during pregnancy and the postpartum period to avoid PPDS.
       
  • Toward a Very Brief Quality of Life Enjoyment and Satisfaction
           Questionnaire
    • Abstract: Publication date: Available online 15 August 2018Source: Journal of Affective DisordersAuthor(s): A. John Rush, Charles C. South, Manish K. Jha, Bruce D. Grannemann, Madhukar H. TrivediAbstractObjectiveTo develop and evaluate a new brief self-report measure of satisfaction/quality of life in depressed outpatients.MethodsUsing the Quality of Life Enjoyment and Satisfaction Questionnaire Short-Form (Q-LES-Q-SF) self-report from Step-1 (n=2181) of the STAR*D trial, items were selected based on their magnitude of change with treatment and correlation with 16-item Quick Inventory of Depressive Symptomatology Self-Report (QIDS-SR16). Psychometric analyses were conducted. Replication of scale performance was assessed with STAR*D Step-2 data (n=250).ResultsThe 7 items selected (“Mini-Q-LES-Q”) rated satisfaction with work, household activities, social and family relations, leisure time activities, daily function and sense of well-being in the past week. This uni-dimensional scale captured 83-94% variance in Q-LES-Q-SF and had acceptable Item Response and Classical Test Theory characteristics. Baseline to exit percent changes in the Mini-Q-LES-Q and the QIDS-SR16 were significantly, modestly related (r= -0.552) (Step-1) and replicated (r= -0.562) (Step-2). The Mini-Q-LES-Q detected the expected improvement in satisfaction/quality of life in acute treatment, yet also identified residual deficits expected in many at acute-phase exit.LimitationsPopulation norms are yet undefined. Concurrent validity with detailed, well-validated scales that assess the seven Quality of Life domains incorporated in the Mini-Q-LES-Q remains unestablished. Sensitivity to symptom changes induced by psychotherapy or somatic therapies or sensitive to the effects of therapies aimed at enhancing quality of life enjoyment and function is unknown.ConclusionThe 7-item Mini-Q-LES-Q self-report measure satisfaction/quality of life has acceptable psychometric properties, reflects change with depressive symptom reduction, and detects residual deficits in this key clinical outcome.
       
  • Cognitive biases predict symptoms of depression, anxiety and wellbeing
           above and beyond neuroticism in adolescence
    • Abstract: Publication date: Available online 15 August 2018Source: Journal of Affective DisordersAuthor(s): Eilidh M Smith, Shirley Reynolds, Faith Orchard, Heather C Whalley, Stella WY ChanAbstractBackground: Adolescence represents a period of vulnerability to affective disorders. Neuroticism is considered a heritable risk factor for depression, but is not directly amenable to intervention. Therefore, it is important to identify the contributions of modifiable risk factors. Negative cognitive biases are implicated in the onset and maintenance of affective disorders in adults, and may represent modifiable risk factors in adolescence.Aim(s): This study sought to assess to what extent cognitive biases are able to predict depression, anxiety and wellbeing beyond that of neuroticism in adolescents.Methods: Adolescents (N=99), recruited from Scottish secondary schools (54.5% female; mean age=14.7), ensured a sample representing the breadth of the mental health spectrum. In line with prevalence estimates, 18% of this sample demonstrated clinical levels of depression symptoms. Cognitive biases of autobiographical memory, self-referential memory, ambiguous scenarios interpretation, facial expression recognition, rumination and dysfunctional attitudes were assessed. Depression, anxiety, and wellbeing were indexed using the Mood and Feelings Questionnaire, Spence Children's Anxiety Scale and the BBC Subjective Wellbeing Scale.Results: Regression analyses demonstrated neuroticism to significantly predict depression, anxiety and wellbeing. The addition of cognitive biases resulted in a significant increase of explained variance with final models explaining just over 50% of variances of depression, anxiety and wellbeing.Conclusion: These findings demonstrate that cognitive biases explain mental health symptoms over and above that of neuroticism. Depressive symptomology was particularly related to self-referential memory bias, while anxiety was predicted by interpretive bias. The key clinical implication is that targeting specific biases based on diagnostic features may be of particular benefit in alleviating distress and promoting wellbeing.
       
  • A meta-analysis of Selective Serotonin Reuptake Inhibitors (SSRIs) use
           during prenatal depression and risk of low birth weight and small for
           gestational age
    • Abstract: Publication date: Available online 15 August 2018Source: Journal of Affective DisordersAuthor(s): Xiaofeng Zhao, Qian Liu, Suxia Cao, Jianyue Pang, Huijie Zhang, Tingting Feng, Yajie Deng, Jing Yao, Hengfen LiAbstractBackground: Selective Serotonin Reuptake Inhibitors (SSRIs) act as the first-line antidepressants prescribed for the treatment of prenatal depression. Evidence from previous studies has suggested that the use of SSRIs treatment for prenatal depression has adversely affected fetal growth. However, these results are inconsistent and inconclusive.Methods: In this study, we examined whether SSRIs use during pregnancy was related to low birth weight (LBW) and small for gestational age (SGA) using a meta-analysis approach. Relevant studies were retrieved by database searching and selected according to established inclusion criteria.Results: Fifteen articles involved 1,977,446 subjects were identified that tested the relationship between the SSRIs use, LBW and SGA outcomes. Statistical analyses revealed a significant association between SSRIs use and suboptimal fetal growth (RR = 1.45, 95% CI = 1.18−1.76, Z = 3.62, p = 0.00 for SGA; RR = 1.38, 95% CI = 1.13−1.69, Z = 3.14, p = 0.00 for LBW).Limitations: These results must be treated with caution as we did not take the confounding factors into account (e.g. trimester SSRIs taken, specific SSRIs prescribed and maternal lifestyle during pregnancy) to elucidate their specific roles in the relationship between SSRIs use during pregnancy and fetal growth.Conclusion: Our findings suggested that SSRIs use for prenatal depression is associated with suboptimal fetal growth.
       
  • Depression literacy and stigma influence how parents perceive and respond
           to adolescent depressive symptoms
    • Abstract: Publication date: Available online 15 August 2018Source: Journal of Affective DisordersAuthor(s): Carly Johnco, Ronald M. RapeeAbstractBACKGROUND: This study aimed to: 1) validate a measure of parental reactions, attitudes and understanding of adolescent depressive symptoms (PRAUD); and 2) examine the impact of adolescent and parent depressive symptoms, parental knowledge about adolescent depression (depression literacy), and parental depression stigma on parental responses to adolescent depression.METHOD: Parents (N = 440) of adolescents aged 13-17 years completed an anonymous online questionnaire.RESULTS: Factor analysis suggested four patterns of parental responses to adolescent depressive symptoms: overprotection, criticism, distress and support. Internal consistency was good for all PRAUD subscales (α=.80-.88). Higher parent and adolescent depressive symptoms, greater depression stigma and lower depression literacy were associated with more negative parental responses. Higher adolescent depressive symptoms and poorer parent depression literacy predicted overprotective responses, and depression stigma moderated the effect of parent depressive symptoms. Depression literacy moderated the effect of parent depression on supportive parental responses, and stigma moderated the effect of adolescent depression. Higher levels of depression stigma and parent depression predicted critical responses, and depression literacy moderated the effect of adolescent depressive symptoms. Distress responses were predicted by higher stigma, and depression literacy moderated the effect of parent and adolescent depressive symptoms.LIMITATIONS: Differences between the two sample recruitment sites.CONCLUSIONS: There was evidence of more negative parental attitudes and responses among depressed parents and parents of depressed youth. Improving parental depression literacy and reducing depression stigma during treatment of adolescent depression may facilitate parental responsiveness, and in some circumstances, may help buffer against the negative impact of parental depression.
       
  • Long-term treatment response to continuous cycling course in bipolar
           disorders: A meta-analysis.
    • Abstract: Publication date: Available online 14 August 2018Source: Journal of Affective DisordersAuthor(s): Antonio Tundo, Franco De Crescenzo, Davide Gori, Paola CavalieriAbstractOBJECTIVEAbout 30% of patients with bipolar disorders (BD) exhibit a continuous cycling course (CCC). These patients significantly differ from those with non-continuous cycling course (N-CCC) on clinical presentation and have a poorer short-term response to antidepressant treatment. Our aim is to conduct a meta-analysis of the studies comparing long-term treatment response in CCC and N-CCC bipolar patients.METHODWe conducted a systematic review of studies on patients with a diagnosis of bipolar disorder with CCC. Our primary outcome measure was the response to treatment at the last follow-up visit. The data analysis was based on the success rate difference as the effect size measure. To account for heterogeneity of primary studies, aggregation of results was based on a random-effects model.RESULTSWe included six observational studies comprising a total of 671 patients (CCC 29.4%, N-CCC 70.6%). Overall, the response rate was 34.0% in the CCC and 49.3% in the N-CCC arm. The meta-analysis shows a significant association between cycle pattern and response (success rate difference: -0.17; 95%CI: -0.25, -0.09; p
       
  • Applications of machine learning algorithms to predict therapeutic
           outcomes in depression: a meta-analysis and systematic review
    • Abstract: Publication date: Available online 14 August 2018Source: Journal of Affective DisordersAuthor(s): Yena Lee, Renee-Marie Ragguett, Rodrigo B. Mansur, Justin J. Boutilier, Joshua D. Rosenblat, Alisson Trevizol, Elisa Brietzke, Kangguang Lin, Zihang Pan, Mehala Subramaniapillai, Timothy C.Y. Chan, Dominika Fus, Caroline Park, Natalie Musial, Hannah Zuckerman, Vincent Chin-Hung Chen, Roger Ho, Carola Rong, Roger S. McIntyreAbstractBackground: No previous study has comprehensively reviewed the application of machine learning algorithms in mood disorders populations. Herein, we qualitatively and quantitatively evaluate previous studies of machine learning-devised models that predict therapeutic outcomes in mood disorders populations.Methods: We searched Ovid MEDLINE/PubMed from inception to February 8, 2018 for relevant studies that included adults with bipolar or unipolar depression; assessed therapeutic outcomes with a pharmacological, neuromodulatory, or manual-based psychotherapeutic intervention for depression; applied a machine learning algorithm; and reported predictors of therapeutic response. A random-effects meta-analysis of proportions and meta-regression analyses were conducted.Results: We identified 639 records: 75 full-text publications were assessed for eligibility; 26 studies (n=17,499) and 20 studies (n=6,325) were included in qualitative and quantitative review, respectively. Classification algorithms were able to predict therapeutic outcomes with an overall accuracy of 0.82 (95% confidence interval [CI] of [0.77, 0.87]). Pooled estimates of classification accuracy were significantly greater (p 
       
  • Affective instability in those with and without mental disorders: a case
           control study
    • Abstract: Publication date: Available online 14 August 2018Source: Journal of Affective DisordersAuthor(s): Steven Marwaha, Charlotte Price, Jan Scott, Scott Weich, Aimee Cairns, Jeremy Dale, Catherine Winsper, Matthew R. BroomeAbstractBackgroundAffective instability (AI) is transdiagnostic, and associated with suicidality and healthcare use. It has rarely been compared between diagnoses or to controls. We investigated: whether AI differs between clinical cases and controls and between diagnoses; how different AI components are correlated; and whether AI is associated with functioning in clinical cases.MethodsCases (N=69) from psychiatric services had a diagnosis of borderline personality disorder, bipolar disorder, major depression or psychosis and were compared to primary care controls (N=25). Participants completed the affective lability scale (ALS), affective intensity measure (AIM), affective control scale (ACS), scored mood fluctuation rate and the WHO-DAS.ResultsThere was a significant difference in affective lability between cases and controls and across diagnostic groups (p< 0.001). Compared to controls, cases showed lower affective control (p
       
  • Differentiating responders and non-responders to rTMS treatment for
           depression after one week using resting EEG connectivity measures
    • Abstract: Publication date: Available online 14 August 2018Source: Journal of Affective DisordersAuthor(s): NW Bailey, KE Hoy, NC Rogasch, RH Thomson, S McQueen, D Elliot, CM Sullivan, BD Fulcher, ZJ Daskalakis, PB FitzgeraldAbstractBackgroundNon-response to repetitive transcranial magnetic stimulation (rTMS) treatment for depression is costly for both patients and clinics. Simple and cheap methods to predict response would reduce this burden. Resting EEG measures differentiate responders from non-responders, so may have utility for response prediction.MethodsFifty patients with treatment resistant depression and 21 controls had resting electroencephalography (EEG) recorded at baseline (BL). Patients underwent 5-8 weeks of rTMS treatment, with EEG recordings repeated at week 1 (W1). Forty-two participants had valid BL and W1 EEG data, and 12 were responders. Responders and non-responders were compared at BL and W1 in measures of theta (4-8 Hz) and alpha (8-13 Hz) power and connectivity, frontal theta cordance and alpha peak frequency. Control group comparisons were made for measures that differed between responders and non-responders. A machine learning algorithm assessed the potential to differentiate responders from non-responders using EEG measures in combination with change in depression scores from BL to W1.ResultsResponders showed elevated theta connectivity across BL and W1. No other EEG measures differed between groups. Responders could be distinguished from non-responders with a mean sensitivity of 0.84 (p = 0.001) and specificity of 0.89 (p = 0.002) using cross-validated machine learning classification on the combination of all EEG and mood measures.LimitationsThe low response rate limited our sample size to only 12 responders.ConclusionResting theta connectivity at BL and W1 differ between responders and non-responders, and show potential for predicting response to rTMS treatment for depression.
       
  • Major Depressive Episodes and Mortality in the Canadian Household
           Population
    • Abstract: Publication date: Available online 14 August 2018Source: Journal of Affective DisordersAuthor(s): Scott B. Patten, Jeanne VA Williams, Andrew GM BullochAbstractObjectiveTo explore the association between major depressive episodes (MDE) and subsequent mortality in a representative sample of the general household population, with adjustment for other determinants of mortality.MethodThe analysis used four datasets from the Canadian Community Health Survey (CCHS); the CCHS 1.1 (conducted in 2000 and 2001), the CCHS 1.2 (conducted in 2002), the CCHS 2.1 (conducted in 2003 and 2004) and the CCHS 3.1 (conducted in 2005 and 2006). Each survey included an assessment of past-year major depressive episodes (MDEs) and was linked to mortality data from the Canadian Mortality Database for January 1, 2000 to December 31, 2011. The hazard ratio (HR) for all-cause mortality was estimated in each survey sample. Random effects, individual-level meta-analysis was used to pool estimates from the four survey data sets. Estimates were adjusted for other determinants of mortality prior to pooling in order to help quantify the independence contribution of MDE to all-cause mortality.ResultsThe unadjusted HR was 0.77 (95% CI 0.63 – 0.95). A naïve interpretation of this HR suggests a protective effect of MDE, but the estimate was found to be strongly confounded by age (age adjusted HR for MDE: 1.61, 95% CI 1. 34 – 1.93) and by sex (sex adjusted HR for MDE: 1.15, 95% CI 0.75 – 1.77). The age and sex adjusted HR was: 1.70 (95% CI 1.45 – 2.00). No evidence of effect modification by any determinant of mortality was found, including sex. After adjustment for a set of mortality risk factors, the pooled HR was weakened, but remained statistically significant, HR = 1.29 (I-squared = 
       
  • Understanding suicide: Focusing on its mechanisms through a lithium lens
    • Abstract: Publication date: Available online 14 August 2018Source: Journal of Affective DisordersAuthor(s): Gin S Malhi, Pritha Das, Tim Outhred, Lauren Irwin, Grace Morris, Amber Hamilton, Katie Lynch, Zola MannieAbstractBackgroundCurrent intervention strategies have been slow in reducing suicide rates, particularly in mood disorders. Thus, for intervention and prevention, a new approach is necessary. Investigating the effects of a medication known for its anti-suicidal properties on neurobiological and neurocognitive substrates of suicidal thinking may provide a deeper and more meaningful understanding of suicide.MethodA literature search of recognised databases was conducted to examine the intersection of suicide, mood disorders, and the mechanisms of lithium.ResultsThis review synthesises the extant evidence of putative suicide biomarkers and endophenotypes and melds these with known actions of lithium to provide a comprehensive picture of processes underlying suicide. Specifically, the central importance of glycogen synthase kinase-3β (GSK3β) is discussed in detail because it modulates multiple systems that have been repeatedly implicated in suicide, and which lithium also exerts effects on.LimitationsSuicide also occurs outside of mood disorders but we limited our discussion to mood because of our focus on lithium and extending our existing model of suicidal thinking and behaviour that is contextualised within mood disorders.ConclusionsFocusing on the neurobiological mechanisms underpinning suicidal thinking and behaviours through a lithium lens identifies important targets for assessment and intervention. The use of objective measures is critical and using these within a framework that integrates findings from different perspectives and domains of research is likely to yield replicable and validated markers that can be employed both clinically and for further investigation of this complex phenomenon.
       
  • The relations between empathy, guilt, shame and depression in inpatient
           adolescents
    • Abstract: Publication date: Available online 14 August 2018Source: Journal of Affective DisordersAuthor(s): Malgorzata Gambin, Carla SharpAbstractBackgroundHigh levels of affective empathy are associated with increased levels of depressive symptoms. However, studies investigating the mechanisms underlying this relation are limited. Since affective empathy may be associated with a feeling of exaggerated responsibility for alleviating the suffering of others, it may lead to high levels of generalized guilt and various forms of shame, which, in turn, may elevate depressive symptoms. Therefore, these self-conscious emotions are candidate mediators of the affective empathy-depressive symptoms relationship. Accordingly, the aim of the current study was to test the hypothesis that generalized and contextual shame and generalized guilt mediate the relations between affective empathy and depressive symptoms.Methods117 inpatient adolescents completed the Basic Empathy Scale to assess affective and cognitive empathy, the Beck Depression Inventory-II to evaluate severity of depressive symptoms, the Test of Self-Conscious Affect that measures contextual guilt and shame, and the Personal Feelings Questionnaire that assess generalized guilt and shame.ResultsFindings demonstrated that generalized guilt, contextual and generalized shame mediated the relation between affective empathy and depressive symptoms. In contrast, cognitive empathy was shown to be related most strongly to contextual guilt and was unrelated to depressive symptoms.LimitationsCharacteristics of the sample (predominately Caucasian inpatient adolescents from well-educated and financially stable environments), the lack of a longitudinal design, and over-reliance on self-report measures were main limitations of the study.ConclusionsThe study provides novel information on the mechanisms underlying the association between affective empathy and depressive symptoms and shows that shame and generalized guilt associated with affective sharing should be considered as possible targets for therapeutic/preventive interventions for adolescents with high levels of depressive symptoms.
       
  • Proximally-Occurring Life Events and the First Transition from Suicidal
           Ideation to Suicide Attempt in Adolescents
    • Abstract: Publication date: Available online 14 August 2018Source: Journal of Affective DisordersAuthor(s): Elise PaulAbstractBackgroundInformed by diathesis-stress models of suicide risk, this paper investigated the role of proximally-occurring stressful life events in the first transition from suicidal ideation to suicide attempt in adolescence. Interactions between stressful life events and psychiatric disorders in relation to this progression were also examined.MethodsData are from a subsample (N = 928) of adolescents with lifetime suicidal ideation from the National Comorbidity Survey-Adolescent Supplement. Logistic regression analyses compared adolescents who had transitioned to a first suicide attempt (n = 81) in the year prior to the study to adolescents with suicidal ideation only (n = 847).ResultsMultivariate logistic regressions implicated increased risk for progression from suicidal ideation to a first suicide attempt in the presence of a recent romantic break-up as well as more recent stressful life events. However, among adolescents with suicidal ideation and either a recent romantic break-up or above-average recent stressors, neither a disruptive behavior disorder, mood disorder, nor a substance use disorder intensified the risk for progressing to a first suicide attempt.LimitationsAnalyses are cross-sectional and therefore limit causal inferences.ConclusionsFindings underscore the importance of comprehensive suicide risk evaluations that consider proximally-occurring interpersonal stressors which may influence the first transition from thinking about suicide to acting in adolescence.
       
  • OpenSIMPLe: A real-world implementation feasibility study of a
           smartphone-based psychoeducation programme for bipolar disorder
    • Abstract: Publication date: Available online 14 August 2018Source: Journal of Affective DisordersAuthor(s): Diego Hidalgo-Mazzei, María Reinares, Ainoa Mateu, Viktoriya L Nikolova, Caterina del Mar Bonnín, Ludovic Samalin, Aitana García-Estela, Víctor Pérez-Solá, Allan H. Young, Sergio Strejilevich, Eduard Vieta, Francesc ColomAbstractBackgroundFew evidence-based mental health apps are widely available to patients and, conversely, many of the available appS HAVEN´T BEEN APPROPRIATELY EVALUATED. GIVEN THAT THE ULTIMATE GOAL IS TO SCALE-UP AND OPEN INTERNET-BASED PLATFORMS (IBP), IT IS CRUCIAL TO APPROPRIATELY EVALUATE THEIR REAL-WORLD FEASIBILITY BEFOREHAND. WE AIMED TO EVALUATE THE IMPLEMENTATION FEASIBILITY OF A SMARTPHONE-BASED PSYCHOEDUCATIONAL PROGRAMME FOR BIPOLAR DISORDER, EXPLORING ITS LONG-TERM RETENTION, USABILITY, PERCEIVED HELPFULNESS AND SATISFACTION, ALONGSIDE ITS IMPACT ON SECONDARY HEALTH OUTCOMES.METHODSPARTICIPANTS WERE RECRUITED VIA THE PROJECT WEBSITE AFTER COMPLETING AN ONLINE SCREENING QUESTIONNAIRE. THEY WERE REQUESTED TO COMPLETE WEB-BASED QUESTIONNAIRES BEFORE USING THE APP AND AFTER 6 MONTHS OF USE WHICH INCLUDED SOCIODEMOGRAPHIC, ILLNESS AND TREATMENT VARIABLES, THE WORLD HEALTH ORGANISATION-FIVE WELL-BEING INDEX (WHO-5) AND THE SHORT FORM HEALTH SURVEY (SF-36). THE FOLLOW-UP QUESTIONNAIRES ALSO CONTAINED SATISFACTION AND USEFULNESS QUESTIONS.RESULTS201 PARTICIPANTS TOOK PART IN THE STUDY. ACCORDING TO THEIR RETENTION, 66.2% OF THE PARTICIPANTS WERE CLASSIFIED AS NON-COMPLETERS AND 33.8% AS COMPLETERS. THE ONLY PREDICTOR SIGNIFICANTLY ASSOCIATED WITH HIGHER ODDS OF RETENTION WAS OLDER AGE (OR=1.021, P
       
  • Narcissistic Traits and Self-Esteem in Children: Results from a Community
           and a Clinical Sample of Patients with Oppositional Defiant Disorder
    • Abstract: Publication date: Available online 13 August 2018Source: Journal of Affective DisordersAuthor(s): Pietro Muratori, Annarita Milone, Paola Brovedani, Valentina Levantini, Gabriele Melli, Simone Pisano, Elena Valente, Sander Thomaes, Gabriele MasiAbstractBackgroundSeveral studies have investigated relationships between narcissism, self-esteem and behavioral problems in children. Most of these studies have been conducted in community samples, rather than in clinical referred samples. This field of research is clinically important, because data on community samples suggest that narcissism is a significant risk factor for children's behavioral problems.MethodsThe study aimed to test the psychometric properties of the Child Narcissism Scale (CNS) in a community sample of Italian children and to explore the clinical utility of CNS in a sample of referred children with Oppositional Defiant Disorder (ODD).ResultsIn the community sample, the Italian version of the CNS was shown to be a normally distributed, single-factor measure of childhood narcissism with very good internal consistency. Furthermore, high levels of narcissism were associated with less self-esteem in family relationships, more parent-reported conduct problems, and less teacher-reported pro-social behaviors. In the ODD sample, high levels of narcissism were associated with more conduct problems and emotional symptoms. Low levels of self-esteem were associated with more conduct problems.LimitationsThe cross sectional design does not allow for estimates of CNS test-retest reliability and sensitivity to change, nor does it allow for interpretations that suggest temporal precedence or causality.ConclusionsWe found support for the cross-cultural utility of the CNS as a short and comprehensive self-report measure of narcissistic traits, which can be used in community and clinical samples of children, and suggested how narcissism may be involved in children's behavioral problems.
       
  • Effects of maternal anxiety and depression on fetal neuro-development
    • Abstract: Publication date: Available online 13 August 2018Source: Journal of Affective DisordersAuthor(s): N. Reissland, S. Froggatt, E. Reames, J. GirkinBackground: Fetal development is affected by maternal mental health with research indicating that maternal anxiety and depression are co-morbid; nevertheless differential effects on the fetus have been found. This study examines, prenatally, effects of maternal stress, anxiety and depression on fetal eye-blink reactions to experimental sound and light stimulation.Methods: Two groups of singleton fetuses (mean 32-weeks gestation) were examined using 4D ultrasound: a control group (N= 14, 7 female) with no stimulation and an experimental group (N=21, 13 female) exposed to experimental sound, light and cross-modal stimulation.   For both groups ultrasound scans were performed and fetal eye-blink was assessed.  Mothers completed the Hospital-Anxiety-and-Depression Scale and the Perceived-Stress Scale. Analysis was carried out using Poisson mixed effects modelling.Results: Fetal eye-blink rate during experimental stimulation was significantly and differentially associated with maternal mental health with a 20% increase of fetal eye-blink rate for each unit increase in anxiety score (p=0.02) and a decrease of 21% of eye blink rate for each unit of increase in depression score (p=0.02). Sound stimulation but not light stimulation significantly affected blink-rate with fetuses habituating to the stimuli (p
       
  • Capacity to Provide Informed Consent among Adults with Bipolar Disorder
    • Abstract: Publication date: Available online 13 August 2018Source: Journal of Affective DisordersAuthor(s): Christina C. Klein, Michelle B. Jolson, Meg Lazarus, Brian Masterson, Thomas J. Blom, Caleb M. Adler, Melissa P. DelBello, Stephen M. StrakowskiAbstractBackgroundIdentifying correlates of capacity to provide informed consent among individuals with bipolar disorder is essential for patient protection. As part of a clinical trial involving approved, standard treatments, we investigated relationships between clinical characteristics and capacity to provide informed consent in adults with bipolar disorder using the MacArthur Competence Assessment Tool for Clinical Research (MacCAT-CR). After administering the MacCAT-CR, continuing participants in the trial were capable of and provided informed consent.MethodsTrained, board-certified psychiatrists administered the MacCAT-CR to potential study participants (N=50) after they provided informed consent, but prior to initiation of study procedures.ResultsHigher Schedule for Assessment of Positive Symptoms (SAPS) scores were significantly correlated with worse MacCAT-CR Understanding and Appreciation (p
       
  • Gender-specific study of recurrent suicide attempts in outpatients with
           multiple substance use disorders
    • Abstract: Publication date: Available online 13 August 2018Source: Journal of Affective DisordersAuthor(s): R. Icick, F. Vorspan, E. Karsinti, K. Ksouda, J-P. Lépine, G. Brousse, S. Mouly, F. Bellivier, V. BlochAbstractBackgroundpeople suffering from substance use disorders (SUD) often die by suicide, so that the prevention of suicide attempts (SA) remains a top priority in this population. SA recurrence is common and is associated with suicide death, but this phenotype has been overlooked in SUD populations. Thus, we aimed at identifying the risk factors of SA recurrence in SUD, controlling for both gender and levels of exposure to addictive substances, including tobacco.Methodswe consecutively recruited 433 treatment-seeking outpatients with either opiate or cocaine use disorder and assessed their lifetime history of addictive and suicidal symptoms by standardized questionnaires. They were reliably classified as never, single or recurrent (≥2) suicide attempters, whose characteristics were identified by multinomial regression, stratified by gender; and compared to our previous work on serious SA in order to identify common or different risk profiles. Results: 86/140 (61%) suicide attempters reported recurrence. The mean number of SA was 3.1. Recurrence was independently associated with psychiatric hospitalization in both genders, with nicotine dependence in men and with sedative use disorders in women.Limitationspsychiatric diagnoses were derived from the current medication regimen.ConclusionSpecific and possibly avoidable/treatable risk factors for the recurrence of SA in SUD have been identified for the first time, opening new avenues for research and prevention in this high-risk population. Apart from nicotine dependence, these risk factors were very similar to those of serious SA. Although this comparison is indirect for now, it suggests a common liability towards suicidal behavior.
       
  • Estimated prevalence and associated risk factors of attention deficit
           hyperactivity disorder (ADHD) among medical college students in a Chinese
           population
    • Abstract: Publication date: Available online 12 August 2018Source: Journal of Affective DisordersAuthor(s): Yanmei Shen, Bella Siu Man Chan, Jianbo Liu, Fanchao Meng, Tingyu Yang, Yuqiong He, Jianping Lu, Xuerong Luo, Xiang Yang ZhangAbstractBackground: To investigate the prevalence of attention deficit hyperactivity disorder (ADHD) among medical college students in a Chinese population.Methods: A cross-sectional design was used to collect demographic data on participants and their symptoms of ADHD, anxiety, and depression. Data were collected through questionnaires filled out on a computer or through WeChat, a widely used social media app.Results: The prevalence of ADHD among 5693 college students was 3.5% (3.02∼3.98%). Individuals with ADHD showed higher scores on scales of anxiety and depression symptoms (both p
       
  • Treating a broader range of depressed adolescents with combined therapy
    • Abstract: Publication date: Available online 12 August 2018Source: Journal of Affective DisordersAuthor(s): Simon Foster, Prof. Meichun Mohler-KuoAbstractBackgroundTraditional statistical analyses of clinical trials encompass the central tendency of outcomes and, hence, are restricted to a treatment's average effectiveness. Our aim was to get a more complete picture of the effectiveness of standard treatment options for adolescent depression, by analyzing treatment effects across low, middle, and high levels of response.MethodsSecondary data analysis was performed of the Treatment for Adolescents with Depression Study (TADS, ClinicalTrials.gov, NCT00006286), a randomized controlled trial comparing fluoxetine (FLX), cognitive-behavioral therapy (CBT), and their combination (COMB) against placebo treating adolescents with major depression (n=439). The proportional change from baseline to week 12 in the Children's Depression Rating Scale-Revised was used as an index of response. Response levels were analyzed via quantile regression models, thereby estimating treatment effects across the entire response level distribution, adjusted for baseline depression, study site, and patients’ treatment expectancies.ResultsWhereas CBT was no more effective than placebo across response levels, COMB was more effective than FLX in that its quantile treatment effects were both larger in magnitude and spread out across a broader range of response levels, including the low end of the response level distribution. Cohen's d of the difference was 1.39 (95% confidence interval 1.33-1.45).LimitationsAd-hoc analysis using data from a trial that was not originally designed to accommodate such analysis.ConclusionThe combination of cognitive-behavioral therapy and fluoxetine was more effective than either treatment used alone, not just in average effectiveness, but in the breadth of patients in whom it was effective.
       
  • Abnormal metabolite concentrations and amygdala volume in patients with
           recent-onset posttraumatic stress disorder
    • Abstract: Publication date: Available online 11 August 2018Source: Journal of Affective DisordersAuthor(s): Xiaorui Su, Chunchao Xia, Weina Wang, Huaiqiang Sun, Qiaoyue Tan, Simin Zhang, LingJiang Li, Graham J. Kemp, Qiang Yue, Qiyong GongAbstractBackgroundPrevious studies of posttraumatic stress disorder (PTSD) were mainly of patients at a chronic stage, focusing on brain regions outside the amygdala. The goals of this study were to investigate the early biochemical and structural changes of anterior cingulate cortex (ACC) and amygdala in patients with PTSD and to explore their relationships.MethodsSeventy-eight drug-naïve PTSD subjects and 71 non-PTSD age- and sex-matched control subjects were enrolled, all of whom had suffered the same earthquake about one year before. Single-voxel proton magnetic resonance spectroscopy (1H-MRS) was performed and absolute metabolite concentrations in ACC and bilateral amygdalae were estimated with LCModel. Bilateral amygdalae were manually outlined and their volumes were calculated and corrected for the total intracranial volume.ResultsThe PTSD group showed significantly increased N-acetylaspartate (NAA) concentration in the ACC, increased creatine (Cr) concentration in the left amygdala, and increased myo-inositol (mI) concentration in the right amygdala, compared to non-PTSD controls. The NAA concentration in ACC was negatively correlated with the time since trauma. The PTSD group showed significantly decreased volumes of bilateral amygdalae compared to non-PTSD controls, but amygdala volumes were not correlated with metabolite concentrations.LimitationsLongitudinal studies are needed to explore the metabolic and structural changes of PTSD at different stages. The volume of ACC was not measured.ConclusionsThis concurrent increase in some metabolite concentrations and decrease of amygdala volumes may represent a pattern of biochemical and morphological changes in recent-onset PTSD which is different from that reported in chronic PTSD.
       
  • Cerebral Blood Flow in Bipolar Disorder: A Systematic Review
    • Abstract: Publication date: Available online 11 August 2018Source: Journal of Affective DisordersAuthor(s): Simina Toma, Bradley J. MacIntosh, Walter Swardfager, Benjamin I. GoldsteinABSTRACTBackgroundNeuroimaging of cerebral blood flow (CBF) can inform our understanding of the pathophysiology of bipolar disorder (BD) as there is increasing support for the concept that BD is in part a vascular disease. Despite numerous studies examining CBF in BD, there has not yet been a review of the literature on the topic of CBF in BD.MethodsA systematic review of the literature on CBF in BD was performed using the Preferred Reporting Items for Systematic Reviews and Meta-Analysis (PRISMA). Studies included measured CBF by single-photon emission computerized tomography (SPECT), positron emission tomography (PET), arterial spin labelling (ASL) or perfusion weighted imaging (PWI) in a group of BD patients.ResultsThirty-three studies with a total of 508 subjects with BD and 538 controls were included (n=15 SPECT; n=8 PET; n=7 ASL; n=1 PWI; n=2 other). The majority of studies in BD depression and mania reported widespread resting hypoperfusion in cingulate gyrus, frontal, and anterior temporal regions in comparison to healthy controls (HC). Findings in euthymic BD subjects and in symptomatically heterogeneous groups were less consistent. Studies that examined CBF responses to cognitive or emotional stimuli in BD subjects have reported hypoperfusion or different regions involved in comparison to HC.LimitationsImportant methodological heterogeneity between studies, and small number of subjects per study.ConclusionsThe most consistent findings to date are hypoperfusion in BD mood episodes, and hypoactive CBF responses to emotional or cognitive challenges. Future studies examining CBF are warranted, including prospective studies, studies examining CBF as a treatment target, and multimodal imaging studies.
       
  • LITHIUM-ASSOCIATED ANTERIOR CINGULATE NEUROMETABOLIC PROFILE IN EUTHYMIC
           BIPOLAR I DISORDER: A 1H-MRS STUDY
    • Abstract: Publication date: Available online 10 August 2018Source: Journal of Affective DisordersAuthor(s): Marcio Gerhardt Soeiro-de-Souza, Maria Concepcion Garcia Otaduy, Rodrigo Machado-Vieira, Ricardo Alberto Moreno, Fabiano G. Nery, Claudia Leite, Beny LaferAbstractObjectiveIn the treatment of Bipolar disorder (BD), achieving euthymia is highly complex and usually requires a combination of mood stabilizers. The mechanism of action in stabilizing mood has not been fully elucidated, but alterations in N-Acetylaspartate (NAA), Myo-Inositol (mI) and Choline (Cho) have been implicated. Proton magnetic resonance spectroscopy (1H-MRS) is the gold standard technique for measuring brain NAA, Cho and mI in vivo. The objective of this study was to investigate the association of lithium use in BD type I and brain levels of NAA, mI and Cho in the (anterior cingulate cortex) ACC.Methods129 BD type I subjects and 79 healthy controls (HC) were submitted to a 3-Tesla brain magnetic resonance imaging scan (1H-MRS) using a PRESS ACC single voxel (8cm3) sequence.ResultsBD patients exhibited higher NAA and Cho levels compared to HC. Lithium prescription was associated with lower mI (combination+monotherapy) and higher NAA levels (monotherapy).ConclusionThe results observed add to the knowledge about the mechanisms of action of mood stabilizers on brain metabolites during euthymia. Additionally, the observed decrease in mI levels associated with lithium monotherapy is an in vivo finding that supports the inositol-depletion hypothesis of lithium pharmacodynamics.
       
  • Repetitive negative thinking as a predictor of depression and anxiety: A
           longitudinal cohort study
    • Abstract: Publication date: Available online 10 August 2018Source: Journal of Affective DisordersAuthor(s): Philip Spinhoven, Albert M. van Hemert, Brenda W. PenninxAbstractBackgroundRepetitive Negative Thinking (RNT) is assumed to be a transdiagnostic proximal risk factor in depression and anxiety. We examined the prospective relations of disorder-dependent as well as disorder-independent measures of RNT with depression and anxiety outcomes.MethodsIn a prospective cohort study, 1972 adults completed a 3-year follow-up period (attrition=12.6%). DSM-IV diagnoses were assessed with the CIDI, symptom severity with the IDS and BAI, and RNT with measures for perseverative thinking (PTQ), rumination (LEIDS-R) and worry (PWQ).ResultsThe common dimension of our RNT measurements (according to Confirmatory Factor Analysis) was significantly associated with comorbidity among depressive and among anxiety disorders, severity of depressive and anxiety symptoms, as well as persistence and relapse of depressive and anxiety disorders. Additionally, a specific factor for rumination predicted comorbidity of depressive disorders, comorbidity of anxiety disorders and relapse of depressive disorder, while a specific factor for worry predicted comorbidity of anxiety disorders and relapse of anxiety disorders, although to a lesser extent than general RNT.LimitationsThe present study relied solely on self-report measures of RNT and controlling for baseline demographic and clinical variables greatly attenuated the predictive value of RNT.DiscussionDisorder-independent RNT may be a similar underlying process present across depressive and anxiety disorders. It seems more important than the representation of this process in disorder-specific cognitive content such as rumination in depression and worry in anxiety. RNT as a pathological trait deserves more attention in clinical diagnosis and the transdiagnostic treatment of comorbid depression and anxiety in particular.
       
  • Farming habit, light exposure, physical activity, and depressive symptoms.
           A Cross-Sectional Study of the HEIJO-KYO Cohort
    • Abstract: Publication date: Available online 10 August 2018Source: Journal of Affective DisordersAuthor(s): Yuji Asai, Kenji Obayashi, Masataka Oume, Moe Ogura, Katsuya Takeuchi, Yuki Yamagami, Yoshiaki Tai, Norio Kurumatani, Keigo SaekiAbstractBackgroundBright light therapy and exercise interventions are effective methods for treating seasonal and non-seasonal affective disorders. Synchronization of internal circadian rhythms with the external environment by light therapy and physical activity may partly explain its efficacy. In the present study, we objectively measured daytime light exposure and physical activity in real life situations with elderly participants, and investigated the association between farming habits and the prevalence of depressive symptoms.MethodsThis cross-sectional was conducted among 1005 participants (mean age: 71.5) of a community-based cohort study. Depressive symptoms were assessed by the Geriatric Depression Scale (GDS score ≥6) and administration of antidepressant.ResultsFarming habit with long duration (>7.0 h/week) showed significantly lower odds ratios (OR) for depressive symptoms (adjusted OR 0.63, 95% confidential interval,0.41 to 0.96) compared with participants without farming habit independent of confounders such as age, gender, body mass index smoking, drinking, daytime ambulatory systolic blood pressure, diabetes, living alone, education, income, and daylength. Even in farming with short duration (≤7.0 h/week), we found significant association with lower OR for depressive symptoms (adjusted OR 0.64, 95%CI, 0.42 to 0.97). Light exposure and daytime physical activity measured by wrist actigraphy were significantly higher among participants with longer farming habits (p for trend
       
  • Daytime Midpoint as a Digital Biomarker for Chronotype in Bipolar Disorder
    • Abstract: Publication date: Available online 10 August 2018Source: Journal of Affective DisordersAuthor(s): Christopher N. Kaufmann, Anda Gershon, Colin A. Depp, Shefali Miller, Jamie M. Zeitzer, Terence A. KetterABSTRACTBackgroundBipolar disorder (BD) is associated with later sleep and daily activity (evening rather than morning chronotype). Objective chronotype identification (e.g., based on actigraphs/smartphones) has potential utility, but to date, chronotype has mostly been assessed by questionnaires. Given the ubiquity of accelerometer-based devices (e.g. actigraphs/smartphones) worn/used during daytime and tendency to recharge rather than wear at night, we assessed chronotype using daytime (rather than sleep) interval midpoints.MethodsSixty-one participants with BD type I (BD-I) or II (BD-II) and 61 healthy controls completed 25-50 days of continuous actigraphy. The Composite Scale of Morningness (CSM) was completed by a subset of this group. Daytime activity midpoint was calculated for each daytime interval, excluding naps. Evening chronotype was defined as having a daytime interval midpoint at or after 16:15:00 (4:15:00 PM).ResultsBD versus controls had delayed daytime midpoint (mean±standard deviation) (16:49:07±01:26:19 versus 16:12:51±01:02:14, p
       
  • Low brain-derived neurotrophic factor levels in post-mortem brains of
           older adults with depression and dementia in a large clinicopathological
           sample.
    • Abstract: Publication date: Available online 9 August 2018Source: Journal of Affective DisordersAuthor(s): Paula Villela Nunes, Camila Fernandes Nascimento, Helena Kyunghee Kim, Ana Cristina Andreazza, Helena Paula Brentani, Claudia Kimie Suemoto, Renata Elaine Paraizo Leite, Renata Eloah de Lucena Ferretti-Rebustini, Carlos Augusto Pasqualucci, Ricardo Nitrini, Lea Tenenholz Grinberg, Lionel Trevor Young, Wilson Jacob-Filho, Beny LaferAbstractBackgroundDisturbances in peripheral brain-derived neurotrophic factor (BDNF) have been reported in major depressive disorder (MDD). However, there are no studies measuring BDNF levels directly in post-mortem brains of older subjects with MDD and dementia. We aimed to verify if brain BDNF levels were lower in older adults with lifetime history of MDD with and without dementia.MethodsBDNF levels of post-mortem brains from 80 community-dwelling older individuals with lifetime MDD with and without dementia were compared with levels from 80 controls without lifetime MDD. Participants with no reliable close informant, or with prolonged agonal state were excluded. Lifetime MDD was defined as at least one previous episode according to the Structured Clinical Interview for DSM (SCID).ResultsBDNF levels were lower in the MDD group with dementia than in participants with dementia and without MDD as confirmed by multivariate analysis adjusted for clinical and cardiovascular risk factors (ß=-0.106, 95%CI=-0.204;-0.009, p=0.034). No difference was found in the group with MDD without dementia compared with their controls.Limitationsthe retrospective assessment of a lifetime history of depression may be subject to information bias and this study only establishes a cross-sectional association between lifetime history of MDD and lower levels of BDNF in patients with dementia.ConclusionsIn this community sample of older individuals, lower brain BDNF levels were found in cases with both lifetime MDD and dementia. Low BDNF levels could be a moderator to accelerated brain aging observed in MDD with dementia.
       
  • The cost-utility of stepped-care algorithms according to depression
           guideline recommendations – results of a state-transition model analysis
           
    • Abstract: Publication date: Available online 9 August 2018Source: Journal of Affective DisordersAuthor(s): Jolanda A.C. Meeuwissen, Talitha L. Feenstra, Filip Smit, Matthijs Blankers, Jan Spijker, Claudi L.H. Bockting, Anton J.L.M. van Balkom, Erik BuskensAbstractBackgroundEvidence-based clinical guidelines for major depressive disorder (MDD) recommend stepped-care strategies for sequencing evidence-based treatments conditional on treatment outcomes. This study aims to evaluate the cost-effectiveness of stepped care as recommended by the multidisciplinary clinical guideline vis-à-vis usual care in the Netherlands.MethodsGuideline-congruent care as described in stepped-care algorithms for either mild MDD or moderate and severe MDD was compared with usual care in a health-economic state-transition simulation model. Incremental costs per QALY gained were estimated over five years from a healthcare perspective.ResultsFor mild MDD, the cost-utility analysis showed a 67% likelihood of better health outcomes against lower costs, and 33% likelihood of better outcomes against higher costs, implying dominance of guideline-congruent stepped care. For moderate and severe MDD, the cost-utility analysis indicated a 67% likelihood of health gains at higher costs following the stepped-care approach and 33% likelihood of health gains at lower costs, with a mean ICER of about €3,200 per QALY gained. At a willingness to pay threshold of €20,000 per QALY, the stepped-care algorithms for both mild MDD and moderate or severe MDD is deemed cost-effective compared to usual care with a greater than 95% probability.LimitationsThe findings of our decision-analytic modelling are limited by the accuracy and availability of the underlying evidence. This hampers taking into account all individual differences relevant to optimise treatment to individual needs.ConclusionsIt is highly likely that guideline-congruent stepped care for MDD is cost-effective compared to usual care. Our findings support current guideline recommendations.
       
  • Habenular Connectivity May Predict Treatment Response in Depressed
           Psychiatric Inpatients
    • Abstract: Publication date: Available online 9 August 2018Source: Journal of Affective DisordersAuthor(s): Savannah N. Gosnell, Kaylah N. Curtis, Kenia Velasquez, J. Christopher Fowler, Alok Madan, Wayne Goodman, Ramiro SalasAbstractIntroductionThe habenula (Hb) is a small midbrain structure that signals negative events and may play a major role in the etiology of psychiatric disorders including depression. The lateral Hb has three major efferent connections: serotonergic raphe nuclei, noradrenergic locus coeruleus, and dopaminergic ventral tegmental area/substantia nigra compacta. We wanted to test whether Hb connectivity may be important to predict treatment outcomes in depression patients.MethodsWe studied whether habenular connectivity at admission into a psychiatric clinic can predict treatment response. We used an inpatient sample (N = 175) to assess habenular connectivity (diffusion tensor imaging and resting state functional connectivity (RSFC) between the Hb and its targets) close to admission. In addition, we obtained the Patient Health Questionnaire-depression module (PHQ-9) close to admission and at discharge. Inpatients in the study entered the clinic with at least moderately severe depression (score 15 and up). Inpatients considered treatment resistant had scores of 9 or more at discharge.ResultsCompared to responders, treatment non-responders had lower fractional anisotropy in the right Hb afferent fibers and lower RSFC between right Hb and median raphe, but higher RSFC between left Hb and locus coeruleus. A logistic regression model was significantly different from chance, and explained 27.7% of the variance in treatment resistance (sensitivity = 75%; specificity = 71.9%).DiscussionThe anatomical and functional connectivity of the Hb may be a predictor of treatment success in psychiatric populations. Limitations include the Hb small size and the limited time (5 minutes) of resting state data obtained.
       
  • Older Men with Bipolar Disorder Diagnosed in Early and Later Life:
           Physical Health Morbidity and General Hospital Service Use
    • Abstract: Publication date: Available online 9 August 2018Source: Journal of Affective DisordersAuthor(s): Osvaldo P. Almeida, Graeme J. Hankey, Bu B. Yeap, Jonathan Golledge, Leon FlickerAbstractBackgroundBipolar disorder (BD) has been associated with greater health morbidity burden, but it is unclear if this association is affected by age at the time of diagnosis and how this might impact on the use of general hospital services.MethodsCross-sectional study investigating the prevalence of common medical morbidities among participants with early (EOBD) and late onset diagnosis of BD (LOBD – age at diagnosis ≥ 60 years) derived from a community-representative sample of 37183 men aged 65-85 years. Cohort study over a follow up period of up to 17.7 years investigating the hazard of general hospital use among older men associated with EOBD and LOBD taking into account age and prevalent medical morbidities.Results250 older men had a recorded diagnosis of BD, 75 of whom had LOBD. Diabetes, stroke and diseases of the respiratory and digestive systems were more frequent in men with than without BD. There were no differences in the distribution of medical morbidities between men with EOBD and LOBD. The adjusted hazard ratio (HR) of contact with general hospital services was significantly higher among men with EOBD (HR=1.33; 95%CI=1.14, 1.54) and LOBD (HR=1.27, 95%CI=1.06, 1.51) compared with older men without BD. Older men with EOBD had the highest number of contacts with general hospital services during follow up, although men with EOBD and LOBD did not differ in the number of contacts due to episodes of mania or depression. The medical reasons for contact with general hospital services of men with EOBD and LOBD overlapped but were not identical.ConclusionsOlder men with BD experience greater health morbidity than men without BD. Older men with BD access hospital services for the management of physical morbidities earlier and more frequently than men without BD. Age at the time of diagnosis of BD has limited impact on the risk of contact with general medical services, although subtle differences in the physical morbidity of men with EOBD and LOBD warrant further investigation.
       
  • Naturally absorbed polyunsaturated fatty acids, lithium, and
           suicide-related behaviors: a case-controlled study
    • Abstract: Publication date: Available online 9 August 2018Source: Journal of Affective DisordersAuthor(s): Keiko Kurosawa, Takeshi Terao, Masayuki Kanehisa, Ippei Shiotsuki, Nobuyoshi Ishii, Ryuichi Takenaka, Teruo Sakamoto, Takehisa Matsukawa, Kazuhito Yokoyama, Shuntaro Ando, Atsushi Nishida, Yutaka MatsuokaABSTRACTObjectivePrevious studies have investigated the effects of omega-3, omega-6 and lithium on suicide-related behaviors separately. This study was performed to comprehensively investigate the effects of naturally absorbed EPA, DHA, arachidonic acid and lithium in relation to suicide attempt and deliberate self-harm, with adjustment for each other.MethodsWe analyzed plasma EPA, DHA, arachidonic acid levels and serum lithium levels of 197 patients including 33 patients with suicide attempts, 18 patients with deliberate self-harm, and 146 control patients.ResultsMultivariate logistic regression analysis with adjustment for age, gender, EPA, DHA, arachidonic acid and log-transformed lithium levels revealed that the negative associations with EPA levels (adjusted OR 0•972, 95% CI 0•947-0•997, p=0•031) and log-transformed lithium levels (adjusted OR 0•156, 95% CI 0•038-0•644, p=0•01) and the positive association with DHA levels (adjusted OR 1.026, 95% CI 1.010-1.043, p=0.002) were significant in patients with suicide attempts than in control patients. The analysis also demonstrated that the positive association with arachidonic acid levels (adjusted OR 1•015, 95% CI 1•005-1•025, p=0•004) was significant in patients with deliberate self-harm than in control patients.LimitationsThe limitations are relatively small number of patients and the effects of demographics of individual patients could not be adjusted for the analyses.ConclusionsThe present findings suggest that, as naturally absorbed nutrients, higher EPA and lithium levels may be associated with less suicide attempt, and that higher arachidonic acid levels may be associated with more deliberate self-harm.
       
  • Course of subthreshold depression into a depressive disorder and its risk
           factors
    • Abstract: Publication date: Available online 9 August 2018Source: Journal of Affective DisordersAuthor(s): Marlous Tuithof, Margreet ten Have, Saskia van Dorsselaer, Marloes Kleinjan, Aartjan Beekman, Ron de GraafAbstractBackgroundInformation on the natural course of subthreshold depression and risk factors for the development of a full-blown depressive disorder in the general population is scarce. This information is crucial to understand the development of depression and to advance indicated depression prevention.MethodsUsing longitudinal data from a representative population-based study (the Netherlands Mental Health Survey and Incidence Study-2) we assessed 3-year course of subthreshold depression (depressive symptoms causing clinically significant distress for at least 2 weeks, or for 3 days per month for a year; n=120), compared to an asymptomatic group (n=4,111) and a depressive disorder group (major depression or dysthymia; n=294). Next, risk factors for the development of a depressive disorder among adults with subthreshold depression were determined.ResultsTwelve percent of the subthreshold cases developed a full-blown depressive disorder during 3-year follow-up. Risk factors were lower social support, having recurrent short episodes of depressive symptomatology, remitted and current anxiety disorder, remitted substance use disorder, lifetime suicide thoughts, a chronic physical disorder and diminished mental and physical functioning.LimitationsThe number of subjects with subthreshold depression that developed a depressive disorder was small. This limits the possibility to detect significant risk factors.ConclusionOnly a minority of the subthreshold cases developed a full-blown depressive disorder over three years. This shows that subthreshold depression does not, by itself, carry an a priori risk to warrant focusing indicated prevention. The identified risk factors could help to detect those subthreshold cases in whom depression prevention is economically and practically viable.
       
  • Mental health and psychosocial problems among Chinese left-behind
           children: a cross-sectional comparative study
    • Abstract: Publication date: Available online 9 August 2018Source: Journal of Affective DisordersAuthor(s): Wanjie Tang, Gang Wang, Tao Hu, Qian Dai, Jiajun Xu, Yanchun Yang, Jiuping XuABSTRACTBackgroundSeparation from migrant parents threatens the mental health of approximately 61 million left-behind children(LBC) in China. This study compared the prevalence of mental health and psychosocial problems between LBC and controls in Sichuan province, China.MethodsWe randomly recruited LBC and adolescents aged 12–16 years old from 16 rural high schools in 8 counties in Sichuan province. We compared frequency of school bullying, self-esteem, panic symptoms, depression and severe psychological distress(SPD) between LBC and controls from the same schools. These variables were assessed through face-to-face interviews and self-report questionnaires.ResultsThe prevalence of mental health problems was 43.4% among LBC(n=1663) but 30.8% among controls(n=1683), and the prevalence of specific psychological symptoms was also higher among LBC: SPD, 12.1% vs. 4.8%; panic, 32.4% vs. 22.1%; and depressive symptoms, 26.5% vs. 16.3%. Low self-esteem was more prevalent among LBC(26.6% vs. 18.2%) as was severe school bullying(18.5% vs. 11.3%). Among LBC, low self-esteem was associated with an increased risk of depression or SPD, and school bullying was a significant predictor of depression, panic symptoms and SPD. Low self-esteem and depression increased with longer separation from parents, and this risk was higher when the primary caregivers were LBC themselves or relatives compared to single parents or grandparents.LimitationLBC misbehavior, such as internet addiction, smoking and drinking, may also explain our findings; these factors need to be explored in future studies.ConclusionOur results highlight the urgent need for school-based and targeted interventions for LBC to prevent negative mental health outcomes.
       
  • Bipolar features in major depressive disorder: Results from the Iranian
           mental health survey (IranMHS)
    • Abstract: Publication date: Available online 8 August 2018Source: Journal of Affective DisordersAuthor(s): Masoumeh Amin-Esmaeili, Abbas Motevalian, Afarin Rahimi-Movaghar, Ahmad Hajebi, Vandad Sharifi, Ramin Mojtabai, Shahrokh S GudarziAbstractBackgroundPast research suggests that individuals suffering from depressive disorders with bipolar features might have different clinical outcomes resembling bipolar disorders. The objectives of this study are to determine the prevalence of bipolar features among individuals meeting the criteria for 12-month major depressive disorder (MDD) in the Iranian population and to examine the demographic and clinical characteristics associated with these features.MethodsData were drawn from the Iranian Mental Health Survey (IranMHS), a representative household survey of the Iranian population aged 15-64 years. The study sample consisted of all individuals with a 12-month MDD (n=1014) ascertained by the CIDI 2.1 without a lifetime history of bipolar I or II disorders. Mood Disorder Questionnaire (MDQ) was used to screen the lifetime history of bipolar features among participants with MDD.ResultsAmong participants meeting the 12-month MDD criteria, 22.1% (95% CI: 19.6-24.7) had a lifetime history of bipolar features. Compared with those without these features, participants with bipolar features had higher odds of endorsing suicidal ideations and suicide attempts, comorbid anxiety and substance use disorders, severe impairment, history of psychotic symptoms, some features of atypical depression and fewer depressive symptoms. Associations with comorbid anxiety disorders [Odds Ratio (OR)=1.43; 95% confidence interval (CI): 1.00-2.03] and history of psychotic symptoms (OR=2.63 95% CI: 1.81-3.81) persisted in multivariable models.LimitationRelying on self-reports of lifetime bipolar symptoms which is open to recall bias, and cross-sectional study design which limits interpretation of outcome and course of MDD are two major limitations of this study.ConclusionThe presence of bipolar features is associated with a distinct demographic and clinical profile in MDD. Identifying these cases would enhance the homogeneity of the depressive disorder phenotype in general population surveys. Identifying MDD patients with these features has potential clinical implications.
       
  • Future time perspective, loneliness, and depressive symptoms among
           middle-aged adults: a mediation model
    • Abstract: Publication date: Available online 8 August 2018Source: Journal of Affective DisordersAuthor(s): Yoav S. Bergman, Dikla Segel-KarpasAbstractBackgroundRecent studies have demonstrated the relevance of subjective time perceptions with regard to depressive symptoms among aging and older adults. Moreover, loneliness was found to bear a strong connection to such symptoms. However, little is known about the connection between the three constructs. Accordingly, the current research examines whether the connection between future time perspective and depressive symptoms is mediated by loneliness.MethodsData was collected from 1021 participants aged 50-67 (mean age = 57.89), who completed scales assessing the Future Time Perspective Scale, a scale measuring loneliness, and the Center for Epidemiological Studies Depression Scale (CES-D), and provided relevant socio-demographic information.ResultsFuture time perspective was negatively linked with both loneliness and depressive symptoms. Moreover, loneliness was a significant mediator for the connection between future time perspective and depressive symptoms.LimitationsThe study focused on a specific age range, and employed a cross-sectional design.ConclusionsThis study provides a view into the manner by which subjective perceptions of time are linked with depressive symptoms during the aging process, and highlights the clinical importance of such perceptions to depressive symptoms.
       
  • Passive and Mentally-Active Sedentary Behaviors and Incident Major
           Depressive Disorder: a 13-Year Cohort Study
    • Abstract: Publication date: Available online 8 August 2018Source: Journal of Affective DisordersAuthor(s): Mats Hallgren, Neville Owen, Brendon Stubbs, Zangin Zeebari, Davy Vancampfort, Felipe Schuch, Rino Bellocco, David Dunstan, Ylva Trolle LagerrosAbstractBackgroundRegular physical activity reduces the risk of depression onset and is an effective treatment for mood disorders. Recent studies have reported that sedentary behavior increases the risk of depression in adults, but relationships of different types of sedentary behaviors with depression have not been examined systematically. We explored longitudinal relationships of passive (e.g. watching TV) and mentally-active (e.g. office-work) sedentary behaviors with incident major depressive disorder (MDD).MethodsSelf-report questionnaires were completed by 40,569 Swedish adults in 1997; responses were linked to clinician-diagnosed MDD obtained from medical registers until 2010. Relationships between passive, mentally-active and total SBs with incident MDD were explored using survival analysis with Cox proportional hazards regression. Models controlled for leisure time moderate-vigorous physical activity and occupational physical activity. Moderating effects of gender were examined.ResultsIn fully-adjusted models, including only non-depressed adults at baseline, those reporting ≥3 hours of mentally-active SBs on a typical day (versus
       
  • Prenatal Maternal Anxiety and Children's Brain Structure and Function: A
           Systematic Review of Neuroimaging Studies
    • Abstract: Publication date: Available online 8 August 2018Source: Journal of Affective DisordersAuthor(s): Brianna Adamson, Nicole Letourneau, Catherine LebelAbstractBackground: Maternal anxiety disorders are common during pregnancy and postpartum, and are associated with increased behaviour problems and risk of mental health difficulties in children. Understanding alterations in brain structure and function associated with maternal anxiety may help elucidate potential mechanisms via which high maternal anxiety could affect children.Methods: We conducted a systematic review of extant research studying the associations between prenatal anxiety and children's brain structure and function, as assessed through neuroimaging. Data were gathered in accordance with the PRISMA review guidelines.Results: Ten articles were identified, and all found a significant association between antenatal maternal anxiety and child neurodevelopment. Studies vary considerably in their methods with five studies employing electroencephalography (EEG), one using magnetoencephalography (MEG), and the rest employing magnetic resonance imaging (MRI).Limitations: The heterogeneity of neuroimaging techniques undertaken by the reviewed studies precluded a meta-analysis from being performed. The applicability of this systematic review to clinical practice is also limited given that the studies examined children across a wide age range (neonates to 17 years).Conclusions: From early infancy to late adolescence, findings suggest alterations of brain structure and function in frontal, temporal, and limbic areas in children born to mothers who experienced prenatal anxiety. These brain abnormalities may underlie associations between prenatal anxiety and children's behaviour, though more research incorporating neuroimaging and behavioural data is necessary to determine this.
       
  • The adolescent grief inventory: Development of a novel grief measurement
    • Abstract: Publication date: November 2018Source: Journal of Affective Disorders, Volume 240Author(s): Karl Andriessen, Dusan Hadzi-Pavlovic, Brian Draper, Michael Dudley, Philip B. MitchellAbstractBackgroundTo develop an empirically derived, reliable and valid measure of grief in adolescents, aged 12–18 years old.MethodsAn online survey comprising 59 items derived from a qualitative study of 39 bereaved adolescents, the Hogan Inventory of Bereavement Children and Adolescents (HIB), the Depression, Anxiety and Stress Scales (DASS-21), the Multidimensional Scale of Perceived Social Support (MSPSS), and a series of death- and mental health-related questions, targeted adolescents bereaved when aged 12–18 years, with 176 adolescents (80.6% girls) completing the survey.ResultsFactor Analysis of the 59-items resulted in a final solution, the Adolescent Grief Inventory (AGI) comprised of 40 items and 6 factors: Sadness, Self-blame, Anxiety and Self-harm, Shock, Anger and Betrayal, and Sense of Peace, with indices of good fit (RMSEA = 0.057, CFI = 0.952, TLI = 0.948). There was strong evidence of convergent (HIB) and divergent (MSPSS) validity. Adolescents bereaved by suicide scored higher on Self-blame, Anger and Betrayal while those with a history of suicidal behaviour or having a mental health diagnosis scored higher overall than those who had not.LimitationsStudy limitations include the self-selected, mostly female, sample, a high proportion of participants with a mental health and self-harm history, and reliance on self-reported data.ConclusionsThe AGI is a novel, comprehensive and valid measure of grief in adolescents. It can be used broadly, including with bereaved adolescents at-risk of mental health ramifications.
       
  • Impact of Predominant Polarity on Long-term Outcome in Bipolar Disorder: a
           7-Year Longitudinal Cohort Study
    • Abstract: Publication date: Available online 1 August 2018Source: Journal of Affective DisordersAuthor(s): Gabriel Okawa Belizario, Michelle Silva, Beny LaferAbstractIntroductionRecent studies suggest that Predominant Polarity (PP) may be an important specifier of Bipolar Disorder (BD), establishing distinct groups of patients and providing a potential tool for tailored treatment. PP has been associated to various clinical variables present in the course of the disorder, including deficits in cognitive functioning, suicide attempts, hospitalizations and response to pharmacological treatment. However, most published studies are retrospective and cross-sectional, frequently relying on patients´ ability to recall past information, which may often be inaccurate.MethodsParticipants were recruited from the outpatient clinic of the Bipolar Disorder Research Program at the Institute of Psychiatry of the University of São Paulo. Baseline clinical and demographic variables were collected using a semi-structured questionnaire and the SCID-CV. Longitudinal data were collected through medical records, mood charts, and mood symptom scales conducted throughout a 7-year follow-up period.ResultsManic Predominant Polarity (MPP) was associated with a significantly higher number of hospitalizations, suicide attempts, and episodes with psychotic symptoms throughout the 7-year observed period in comparison to Depressive Predominant Polarity (DPP) and Indefinite Predominant Polarity (IPP) patients. Moreover, baseline PP was significantly associated with 7-year PP, with 67% of patients maintaining their PP both at baseline and after the 7-year follow-up period.LimitationsThe present study is limited due to the statistically small sample size, although, to our knowledge, it is the largest longitudinal study conducted in this topic, and the unequally distributed frequency of patients´ visitations, which may have created intervals of unobserved periods within the follow-up period.DiscussionThe results revealed PP to be an important specifier for predicting the course of the disorder. Overall, MPP was significantly associated with variables indicative of a worse outcome, suggesting that greater attention to preventive treatment should be addressed to this subgroup. Lastly, baseline PP was significantly associated with 7-year observed PP, suggesting that patients tend to remain within the same PP throughout the course of the disorder.
       
  • Latent Trajectory Classes of Postpartum Depressive Symptoms: A Regional
           Population-Based Longitudinal Study
    • Abstract: Publication date: Available online 1 August 2018Source: Journal of Affective DisordersAuthor(s): Filip Drozd, Silje Marie Haga, Lisbeth Valla, Kari SlinningAbstractPurposeThis study aimed to (a) assess trajectories of women's depressive symptoms during the first year postpartum to (b) identify potential unobserved classes of women as defined by their trajectories, (c) identify antepartum and early postpartum risk factors associated with trajectory classes, and (d) examine the association between trajectory classes and counselling during the postpartum period.MethodsData on depressive symptoms, using the Edinburgh Postnatal Depression Scale (EPDS), were collected from 1 374 women across nine Norwegian well-baby clinics at 1.5, 4, 6, and 12 months postpartum. Well-baby clinics offer universal, free services to all families living in the municipality. Thus, there were no specific exclusion criteria for this study. All clinics had implemented the Edinburgh–method which combines screening for PPD, using the EPDS, with supportive counselling.ResultsAnalyses showed that depressive symptoms decreased initially, followed by a flattening in symptoms at 6 months. Mixture analyses, however, identified two classes of women with distinct trajectories; (1) a low-risk (n = 1 249, 91%) and (2) a high-risk group (n = 119, 9%). Complications after birth, elevated prenatal depressive symptoms, previous or current mental illness, and gestational week, predicted trajectory class membership. Women in the high-risk group were more likely to receive counselling than low-risk women.LimitationsWomen had higher educational level than the general population and one of the municipalities did not have a 12-months routine consultation.ConclusionFindings suggest heterogeneity among women in their depressive symptoms during the first year postpartum with a distinct set of risk factors associated with high-risk women. This has implications for the prevention and follow-up of women during pregnancy and the first year after childbirth.
       
  • Child maltreatment, psychopathological symptoms, and onset of diabetes
           mellitus, hypothyroidism and COPD in adulthood
    • Abstract: Publication date: Available online 1 August 2018Source: Journal of Affective DisordersAuthor(s): Mashhood Ahmed SheikhAbstractBackgroundThe aim of this study was to assess the associations between child maltreatment (CM), psychopathological symptoms, and onset of diabetes mellitus, hypothyroidism (i.e., low metabolism), and chronic bronchitis/emphysema/COPD in adulthood.MethodsThe present analysis used data collected in 2007-2008 within the framework of the Tromsø Study, Norway (N=12,981). CM was measured with a single item, and self-reported information on psychopathological symptoms and physical health outcomes was used. The association between CM, psychopathological symptoms, and physical health outcomes was assessed with linear and Poisson regression models. Mediation was assessed with difference-in-coefficients methods.ResultsIn the fully-adjusted models, CM was associated with higher levels of anxiety and depression psychological distress, sleeping difficulty, insomnia, and use of sleeping pills or antidepressants in adulthood (p
       
  • Mindfulness-Based Cognitive Therapy for Bipolar Disorder: A Systematic
           Review
    • Abstract: Publication date: Available online 6 July 2018Source: Journal of Affective DisordersAuthor(s): David A LovasAbstractBackgroundPersisting high levels of relapse, morbidity and mortality in bipolar disorder (BD) in spite of first-line, evidence-based psychopharmacology has spurred development and research on adjunctive psychotherapies. Mindfulness-based cognitive therapy (MBCT) is an emerging psychotherapy that has shown benefit in related and comorbid conditions such as major depressive, anxiety, and substance disorders. Furthermore, neurocognitive studies of MBCT suggest that that may have effects on some of the theorized pathophysiological processes in BD.MethodsWe conducted a systematic literature review using PsychINFO and PubMed databases to identify studies reporting clinical and/or neurocognitive findings for MBCT for BD.ResultsThis search revealed 13 articles. There was a wide range in methodological quality and most studies were underpowered or did not present power calculations. However, MBCT did not appear to precipitate mania, and there is preliminary evidence to support a positive effect on anxiety, residual depression, mood regulation, and broad attentional and frontal-executive control.LimitationsAs meta-analysis is not yet possible due to study heterogeneity and quality, the current review is a narrative synthesis, and therefore net effects cannot be estimated.ConclusionsMBCT for BD holds promise, but more high-quality studies are needed in order to ascertain its clinical efficacy. Recommendations to address the limitations of the current research are made.
       
  • The Risk of Glaucoma and Serotonergic Antidepressants: a Systematic Review
           and Meta-analysis
    • Abstract: Publication date: Available online 31 July 2018Source: Journal of Affective DisordersAuthor(s): Hung-Yu Wang, Ping-Tao Tseng, Brendon Stubbs, Andre F. Carvalho, Dian-Jeng Li, Tien-Yu Chen, Pao-Yen Lin, Yu-Te Hsueh, Yu-Zhen Chen, Yen-Wen Chen, Che-Sheng ChuAbstractBackground: The aim of current study was to conduct a systematic review and meta-analysis to explore the relationship between antidepressant use and glaucoma.Methods: Eight major electronic databases were searched from inception until March 19th, 2018 to obtain relevant studies that evaluated associations of antidepressants [including selective serotonin reuptake inhibitors (SSRIs) and serotonin norepinephrine reuptake inhibitors (SNRIs)] treatment and the risk of primary open-angle glaucoma (POAG) or primary angle-closure glaucoma (PACG) as well as intraocular pressure (IOP), and related anterior chamber parameters compared to participants not exposed to antidepressant treatment. A random-effects meta-analysis was conducted.Results: Six case-control studies and one cohort study were eligible (N=801754). The use of SSRIs was not associated with a higher risk of glaucoma (k=7, pooled adjusted odds ratio (pAOR)=0.956, 95% confidence interval (CI)=0.807 to 1.133, p=0.604). In addition, IOP was lower in participants exposed to antidepressants (SSRIs and SNRIs) (k=4, Hedges’ g=-0.519, 95% CI=-0.743 to -0.296, p
       
  • Characterizing the Course of Suicidal Ideation Response to Ketamine
    • Abstract: Publication date: Available online 30 July 2018Source: Journal of Affective DisordersAuthor(s): Elizabeth D. Ballard, Julia S. Yarrington, Cristan A. Farmer, Erica Richards, Rodrigo Machado-Vieira, Bashkim Kadriu, Mark J. Niciu, Peixiong Yuan, Lawrence Park, Carlos A. ZarateAbstractBackground: No pharmacological treatments exist for active suicidal ideation (SI), but the glutamatergic modulator ketamine elicits rapid changes in SI. We developed data-driven subgroups of SI trajectories after ketamine administration, then evaluated clinical, demographic, and neurobiological factors that might predict SI response to ketamine.Methods: Data were pooled from five clinical ketamine trials. Treatment-resistant inpatients (n=128) with DSM-IV-TR-diagnosed major depressive disorder (MDD) or bipolar depression received one subanesthetic (0.5mg/kg) ketamine infusion over 40 minutes. Composite SI variable scores were analyzed using growth mixture modeling to generate SI response classes, and class membership predictors were evaluated using multinomial logistic regressions. Putative predictors included demographic variables and various peripheral plasma markers.Results: The best-fitting growth mixture model comprised three classes: Non-Responders (29%), Responders (44%), and Remitters (27%). For Responders and Remitters, maximal improvements were achieved by Day1. Improvements in SI occurred independently of improvements in a composite Depressed Mood variable for Responders, and partially independently in Remitters. Indicators of chronic SI and self-injury were associated with belonging to the Non-Responder group. Higher levels of baseline plasma interleukin-5 (IL-5) were linked to Remitters rather than Responders.Limitations: Subjects were not selected for active suicidal thoughts; findings only extend to Day3; and plasma, rather than CSF, markers were used.Conclusion: The results underscore the heterogeneity of SI response to ketamine and its potential independence from changes in Depressed Mood. Individuals reporting symptoms suggesting a longstanding history of chronic SI were less likely to respond or remit post-ketamine.
       
  • Ketamine Augmentation for Major Depressive Disorder and Suicidal Ideation:
           Preliminary Experience in an Inpatient Psychiatry Setting
    • Abstract: Publication date: Available online 29 July 2018Source: Journal of Affective DisordersAuthor(s): Mark Sinyor, Marissa Williams, Sue Belo, Beverley Orser, Margaret Vincent, Linda Mah, Carlos Zarate, Saulo Castel, Anthony J. Levitt, Ayal SchafferAbstractBackground: Ketamine is known to rapidly reduce depressive symptoms and suicidal ideation (SI) in patients with major depressive disorder (MDD), but evidence is limited for its acceptability and effectiveness in “real-world” settings. This case series examines serial ketamine infusions in reducing SI and depression scores in adults with MDD admitted to a tertiary care hospital.Methods: Five inpatients with MDD and SI admitted to hospital in Toronto, Canada received six infusions of 0.5 mg/kg intravenous (IV) ketamine (n=5) over approximately 12 days, in addition to treatment-as-usual. Suicide and depression rating scores (Scale for Suicidal Ideation, SSI; Montgomery-Åsberg Depression Rating Scale, MADRS) were obtained at baseline, on treatment days, on days 14 and 42 (primary endpoint).Results: All patients experienced benefit with ketamine. SSI scores diminished by 84% from 14.0±4.5 at baseline to 2.2±2.5 at study endpoint. MADRS scores diminished by 47% from 42.2±5.3 at baseline to 22.4±8.0. Two patients withdrew from the study, one to initiate electroconvulsive therapy and one due to an adverse event (dissociative effects) during the ketamine infusion.Limitations: The major limitation of this study is the small sample size.Discussion: These preliminary pilot data are promising with a greater than two-fold reduction in SI following ketamine infusions. They demonstrate that six serial ketamine infusions may be safe and feasible. These findings support the need for large scale randomized controlled trials to confirm the efficacy of serial ketamine for treatment of SI in “real-world” settings.
       
  • Cognitive function of patients with treatment-resistant depression after a
           single low dose of ketamine infusion
    • Abstract: Publication date: Available online 27 July 2018Source: Journal of Affective DisordersAuthor(s): Mu-Hong Chen, Cheng-Ta Li, Wei-Chen Lin, Chen-Jee Hong, Pei-Chi Tu, Ya-Mei Bai, Chih-Ming Cheng, Tung-Ping SuAbstractBackgroundClinical and animal studies have reported conflicting results regarding the effect of ketamine on cognitive function, although increasing evidence supports a rapid and sustained antidepressant effect of a subanesthetic dose of ketamine infusion for patients with treatment-resistant depression (TRD). However, the cognitive function before and after ketamine infusion was rarely investigated in patients with TRD.MethodsA total of 71 adult patients with TRD were enrolled and randomized to 0.5-mg/kg ketamine, 0.2-mg/kg ketamine, or normal saline infusion groups. Depressive symptoms were measured using the Hamilton Depression Rating Scale at baseline and at different time points post ketamine infusion. Cognitive function was evaluated using working memory and go/no-go tasks at baseline, Day 3, and Day 14 post ketamine infusion.ResultsA single low dose of ketamine infusion did not impair the cognitive function of patients with TRD. The paired t test revealed that patients with TRD receiving 0.5 mg/kg of ketamine infusion exhibited a slight improvement in sustained attention and response control measured using the go/no-go task at Day 14 post ketamine infusion. A significant association was also observed between depressive symptoms and cognitive function changes at Day 3 in the 0.5-mg/kg ketamine infusion group.DiscussionA 0.5 mg/kg dose of ketamine infusion was not harmful, but slightly beneficial, for the cognitive function of patients with TRD. Additional studies are necessary to elucidate the effects of repeated ketamine infusion on cognitive function.
       
  • Examining components of emotion regulation in relation to sleep problems
           and suicide risk
    • Abstract: Publication date: Available online 27 July 2018Source: Journal of Affective DisordersAuthor(s): Erin F. Ward-Ciesielski, E. Samuel Winer, Christopher W. Drapeau, Michael R. NadorffAbstractBackgroundSleep has emerged as an important factor in elevated risk for suicide and suicidal behaviors; however, the mechanisms accounting for this relationship are poorly understood. Emotion regulation is a well-established correlate of self-injurious behaviors; however, the broad construct has recently been shown to provide limited predictive utility. More nuanced investigations into the processes involved in emotion regulation may address this gap. This study sought to examine the mediating role of emotion regulation between sleep disturbances and suicide risk, as well as to evaluate a moderated mediation model in which down- and up-regulation of emotions would moderate this mediation.MethodsParticipants were 972 adults recruited from a crowdsourcing website (Amazon's Mechanical Turk) who completed self-report questionnaires regarding nightmares, suicide risk, and emotion regulation.ResultsEmotion regulation mediated the direct effect of nightmares on suicide risk and suicide attempts. Downregulation of negative affect moderated the mediation of nightmares on suicide risk more clearly than upregulation of positive affect, and neither component of emotion regulation exhibited moderated mediation in the suicide attempt model.LimitationsGeneralizability of our findings from an online community sample will need to be established with replication in other samples. Additionally, we used cross-sectional measures in our mediation models.ConclusionsDownregulation of negative emotions may be particularly salient in relation to the severity of suicide risk and, as a result, relative deficits in this area should be considered when making risk determinations.
       
  • Loss experiences in old age and their impact on the social network and
           depression– Results of the Leipzig Longitudinal Study of the Aged (LEILA
           75+)
    • Abstract: Publication date: Available online 26 July 2018Source: Journal of Affective DisordersAuthor(s): Franziska Förster, Janine Stein, Margrit Löbner, Alexander Pabst, Matthias C. Angermeyer, Hans-Helmut König, Steffi G. Riedel-HellerAbstractBackgroundLoss experiences and bereavement are common among the oldest old. This study aims to investigate the effects of loss experiences and the social network type on depression in old age.MethodsAs part of the Leipzig Longitudinal Study of the Aged (LEILA 75+), a representative population-based cohort study, 783 persons aged 75+ years were assessed via standardized interviews including the Practitioner Assessment of Network Type Instrument (PANT) and the Center for Epidemiologic Studies-Depression Scale (CES-D). Effects of loss experiences and network type on depression were analysed cross-sectionally (baseline survey) using logistic regressions. Effects over time were analysed longitudinally (follow-up1 and follow-up2) using hybrid techniques.ResultsMore than half of the elderly (57%) continuously lived in a restricted network. Only 12.1% lived in an integrated network. Although 30.9% had a change in their network, no significant association with loss experiences was found. Nevertheless, loss experiences (OR 7.56 (1.60-35.72)) and a restricted social network (OR 4.08 (1.52-10.95)) appeared to be the significant predictors of depression.LimitationsOur study captures only a selected time window of the individual life and loss experience was only assessed at the time of the baseline survey.ConclusionOur findings revealed that elderly individuals, who experienced social loss or lived in restricted social networks, were more likely to develop depression compared to individuals who lived in integrated social networks or without loss experiences. The social integration of elderly individuals is an urgent issue that should be addressed in order to reduce depression in old age.
       
  • Early weight gain predicts later weight gain in depressed patients treated
           with antidepressants: findings from the METADAP cohort
    • Abstract: Publication date: Available online 26 July 2018Source: Journal of Affective DisordersAuthor(s): Khalil El Asmar, Bruno Fève, Romain Colle, Florence Gressier, Albane Vievard, Séverine Trabado, Céline Verstuyft, Emmanuel Haffen, Mircea Polosan, Florian Ferreri, Bruno Falissard, Philippe Chanson, Laurent Becquemont, Emmanuelle CorrubleAbstractBackgroundWeight gain is a major side effect of antidepressant (AD) drugs. We assessed whether early weight gain is a predictor for long term weight gain in depressed patients treated with antidepressants.MethodsIn the six month prospective METADAP cohort, 260 non-overweight patients with a Major Depressive Disorder (MDD), who have recently experienced a Major Depressive Episode (MDE) were assessed for early weight gain (>3%,>5%, and>7%) after one month of treatment, and for long term weight gain (>15% and>20%) after three and six months of treatment. ROC analysis was used to determine the predictive power of early weight gain.Results12.4% (21/170) of patients became overweight after three months of treatment and 21.1% (26/123) were overweight after six months. Compared to non-early weight gainers, patients with early weight gain (>3%,>5% and>7%) were 11.3 (OR=11.3, 95%CI: 4.6-27.6)], 9.9 (OR=9.9, 95%CI: 3.6-26.9)] and 17.8 (OR=17.8, 95%CI: 6.4-49.4)] times, respectively, more at risk of late weight gain (>15%). ROC analysis showed that early weight gain (>3%) after one month of treatment, was the best predictor of long term weight gain (≥15%) after three months [Area Under the Curve (AUC)= 87%] and six months of treatment (AUC= 88%)PerspectivesGiven that our baseline sample consisted of strictly non-overweight patients, the 3% threshold for weight gain after one month should be used as an indicator to initiate early weight monitoring in depressed patients treated with antidepressants. High attrition rate remains a limitation in this cohort and other cohorts in psychiatric settings.DisclosuresBruno Falissard consults for and received lecture fees from for E. Lilly, BMS, Servier, Sanofi-Aventis, GlaxoSmithKline, HRA, Roche, Boeringer Ingelheim, Bayer, Almirall, Allergan, Stallergene, Genzyme, Pierre Fabre, Astra Zeneca, Novartis, Janssen, Astellas, Biotronik, Daiichi-Sankyo, Gilead, MSD, Lundbeck. Florence Gressier received lecture fees from for Servier, Lundbeck and a grant from Servier. Mircea Polosan consults for and received lecture fees from Astra-Zeneca, Bristol Myers Squibb, Lundbeck, Otsuka and Servier. Emmanuel Haffen consults for and received lecture fees from Astra-Zeneca, Bristol Myers Squibb, Pfizer, Lilly, Lundbeck, Otsuka, Sanofi-Aventis, Servier. Philippe Chanson has received unrestricted research and educational grants from Ipsen, Novartis, Novo-Nordisk, and Pfizer for the Department of Endocrinology and Reproductive Diseases, Hôpitaux Universitaires Paris-Sud and for INSERM U 693. He has served as investigator (principal or coordinator) for clinical trials funded by Novartis, Pfizer, Ipsen, Italopharmaco, Antisense, Prolor Biotech.  He is member of Advisory Boards from Ipsen, Novartis, Viropharma. He gave lectures for Ipsen, Novartis, Pfizer, NovoNordisk. All the fees and honoraria were paid to his Institution. Bruno Falissard consults for and received lecture fees from NovoNordisk, MSD and Sanofi-Aventis. Laurent Bequemont has close family member working at Sanofi-Aventis, consults for Sanofi-Aventis, Pfizer, Servier and received lecture fees from Genzyme, GlaxoSmithKline, Bristol-Myers Squibb and Merck Sharp and Dohme. Khalil El Asmar, Séverine Trabado, Albane Vievard, Céline Verstuyft, Romain Colle and Emmanuelle Corruble have nothing to declare.
       
  • Cortical thickness reductions in the middle frontal cortex in patients
           with panic disorder
    • Abstract: Publication date: Available online 26 July 2018Source: Journal of Affective DisordersAuthor(s): Takeshi Asami, Masao Takaishi, Ryota Nakamura, Haruhisa Yoshida, Asuka Yoshimi, Thomas J. Whitford, Tomio Inoue, Yoshio HirayasuAbstractBackgroundPanic disorder (PD), an anxiety disorder characterized by the recurrence of panic attacks, has been reported to be associated with volumetric changes in several brain regions. There are, however, very few studies investigating abnormalities in cortical thickness, and little is known about the relationship between cortical thickness and social dysfunction in PD.MethodsThirty-eight patients with PD and 38 healthy control participants (HC) were recruited for this study. A whole-brain analysis was performed to evaluate groupwise differences in cortical thickness using the FreeSurfer software. Symptom severity and social functioning were evaluated with the Panic Disorder Severity Scale (PDSS) and the Global Assessment of Functioning (GAF) scale.ResultsThe patients with PD demonstrated a significant reduction in cortical thickness in the left rostral middle frontal cortex (MFC), compared with the HC. Correlational analyses revealed that cortical thickness in the left rostral MFC showed a significant negative relationship with PDSS score and a significant positive relationship with GAF scores in the PD patients.LimitationsAll the patients received medication.ConclusionPD patients showed reduced cortical thickness in the left rostral MFC compared with HC. Furthermore, cortical thickness in this region was associated with patients’ symptom severity and degree of social dysfunction.
       
  • Occupational factors associated with major depressive disorder: A
           Brazilian population-based study
    • Abstract: Publication date: November 2018Source: Journal of Affective Disorders, Volume 240Author(s): Nágila Soares Xavier Oenning, Patrícia Klarmann Ziegelmann, Bárbara Niegia Garcia de Goulart, Isabelle NiedhammerAbstractBackgroundThere have been very few studies exploring the occupational risk factors for major depressive disorder (MDD) in the working populations in Latin America. The aim of this study was to explore the associations between a large set of occupational factors and MDD in the Brazilian working population.MethodsThe study was based on the cross-sectional data from the Brazilian National Health Survey, 2013. 60,202 people were interviewed (response rate: 91.9%). Among them, 36,442 were working, 19,450 men and 16,992 women. MDD was measured using the diagnostic algorithm (DSM-IV criteria) of the PHQ-9. Occupational factors included job characteristics, working time factors, psychosocial work stressors and physico-chemical exposures. Logistic regression models were performed and adjusted for sociodemographic factors. All analyses were conducted using weighted and stratified data by gender.ResultsThe following occupational factors were associated with a higher risk of MDD: working part time (≤20 h a week) and stress at work for both genders, workplace violence, intense physical activity, exposure to noise and chemicals among women, and prolonged exposure to sun among men. Associations of stress and violence at work with MDD were particularly strong.LimitationsCross-sectional study design, healthy worker effect and reporting bias may have impacted the results.ConclusionsThis study, one of the first studies among the Brazilian working population, showed that psychosocial work stressors were the strongest risk factors for MDD. Physico-chemical exposures deserve more attention in association with MDD. Prevention policies oriented toward the work environment may help to prevent depression at the workplace.
       
  • The interrelations among aspects of dyspnea and symptoms of depression in
           COPD patients – a network analysis
    • Abstract: Publication date: November 2018Source: Journal of Affective Disorders, Volume 240Author(s): Michael Schuler, Michael Wittmann, Hermann Faller, Konrad SchultzAbstractBackgroundDepression is a frequent comorbidity in COPD. COPD symptoms such as dyspnea may play an important role in the causal relationship between COPD and depression. We investigated the interrelations among different aspects of dyspnea and other COPD parameters and symptoms of depression in COPD patients.MethodsThis is a secondary analysis of N = 590 COPD patients. At the beginning (T0) and the end (T1) of a 3-week inpatient pulmonary rehabilitation, dyspnea aspects intensity (BORG scale), frequency (2 CCQ items), functioning (CCQ-function) and cognitive/emotional response (2 SGRQ items) as well as cough (2 CCQ items), functional capacity (6MWD), lung function (FEV1) and symptoms of depression (PHQ-9) were assessed. Regression analyses with PHQ-9 sum score as dependent variable as well as network analysis using PHQ-9 single items were performed. Structural invariance over time was examined.ResultsDyspnea frequency, function, and cognitive/emotional response showed conditional independent relationships with PHQ-9 sum score. Network analysis showed that dyspnea frequency and dyspnea functioning were primarily associated with somatic depression symptoms (for example, sleep problems, loss of energy), while cognitive/emotional response was primarily related to cognitive-affective depression symptoms (for example, feeling down/depressed/hopeless). Regression parameters, network structure and network global strength did not differ between T0 and T1.LimitationsModels are based on between-person relationships. Results should be confirmed using time-series data.ConclusionsDyspnea and depression seem to be interrelated through a variety of different and complex pathways in COPD patients. Results may be used to explain intervention effects and develop new intervention strategies to reduce depression in COPD.
       
  • Association between parental marital conflict and Internet addiction: A
           moderated mediation analysis
    • Abstract: Publication date: November 2018Source: Journal of Affective Disorders, Volume 240Author(s): Tingting Gao, Xiangfei Meng, Zeying Qin, Han Zhang, Jinglei Gao, Yixi Kong, Yueyang Hu, Songli MeiAbstractBackgroundThe effect of parental marital conflict on Internet addiction has been well-established; however, little is known regarding the underlying mechanism of this effect. The aim of this study was to explore the mediating effect of depression and anxiety, as well as the role of peer attachment as a moderator in this relation between parental marital conflict and Internet addiction.MethodsThe moderated mediation analysis was tested using data from a cross-sectional sample of 2259 high school students who completed questionnaires regarding marital conflict, depression, anxiety, peer attachment and Internet addiction.ResultsThe results indicated that the effect of parental marital conflict on Internet addiction was mediated by depression and anxiety. In addition, peer attachment moderated the association between parental marital conflict and depression/anxiety.ConclusionsThis study helps to elucidate the mechanism underlying the association between parental marital conflict and Internet addiction.
       
  • Education as a moderator in the effect of diabetes on depressive symptoms
           in Chinese middle-aged and older adults: A population-based longitudinal
           study
    • Abstract: Publication date: November 2018Source: Journal of Affective Disorders, Volume 240Author(s): Yanan Luo, Dawei Zhu, Xuefeng Shi, Stephen Nicholas, Ping HeAbstractBackgroundCo-morbid diabetes and depression is common; however, little evidence was regarding the effect of education on this association. This study aimed to investigate the role of education in the effect of diabetes on depressive symptoms in China.MethodsWe used data from the China Health and Retirement Longitudinal Study, including 6,921 participants free from depressive symptoms in three waves of cohort study from 2011. We assessed the depressive symptoms based on Center for Epidemiological Studies–Depression scale. We fitted Cox proportional hazards regression models to examine the effect of baseline diabetes on the subsequent depressive symptoms.ResultsParticipants with diagnosed diabetes were more likely than their nondiabetic peers to develop depressive symptoms only in 45–64 years group, with a hazard ratio of 1.30 (95% CI: 1.05, 1.61). In addition, the effect of diagnosed diabetes on depressive symptoms only occurred in participants with a diploma of primary school or below.LimitationsInformation was unavailable may offer additional explanatory power.ConclusionOur findings suggested that diagnosed diabetes was a chronic stressor in developing depressive symptoms, and that response to this stressor varied by individuals’ educational attainment. Action to prevent and treat diabetes may contribute to the fight against depressive symptoms, especially in the lower-education population.
       
  • Glycogen Synthase Kinase-3β genetic polymorphisms and insomnia in
           depressed patients: a prospective study
    • Abstract: Publication date: Available online 24 July 2018Source: Journal of Affective DisordersAuthor(s): Jean-François Costemale-Lacoste, Romain Colle, Séverine Martin, Khalil El Asmar, Emanuel Loeb, Bruno Feve, Céline Verstuyft, Séverine Trabado, Florian Ferreri, Emmanuel Haffen, Mircea Polosan, Laurent Becquemont, Emmanuelle CorrubleAbstractBackground80-90% of patients with Major Depressive Episode (MDE) experience insomnia and up-to 50% severe insomnia. Glycogen Synthase Kinase-3β (GSK3B) is involved both in mood regulation and circadian rhythm. Since GSK3B polymorphisms could affect protein levels or functionality, we investigated the association of GSK3B polymorphisms with insomnia in a sample of depressed patients treated with antidepressants.MethodsIn this 6-month prospective real-world treatment study in psychiatric settings (METADAP), 492 Caucasian patients requiring a new antidepressant treatment were included and genotyped for five GSK3B Single Nucleotide Polymorphisms (SNPs) (rs6808874, rs6782799, rs2319398, rs13321783, rs334558). Insomnia and MDE severity were rated using the Hamilton Depression Rating Scale (HDRS). Bi- and multivariate analyses were performed to assess the association between GSK3B SNPs and insomnia (main objective). We also assessed their association with MDE severity and HDRS response/remission after antidepressant treatment.Resultsat baseline severe insomnia was associated with the GSK3B rs334558 minor allele (C+) [OR=1.81, CI95%(1.17-2.80), p=0.008]. GSK3B rs334558 C+ had greater insomnia improvement after 6 months of antidepressant treatment (p=0.007, β=0.17, t=2.736). No association was found between GSK3B SNPs and MDE baseline severity or 6-month response/remission.ConclusionGSK3B rs334558 was associated with insomnia but not with MDE severity in depressed patients. Targeting GSK3B in patients with MDE and a severe insomnia could be a way to improve their symptoms with greater efficiency. And it should be further studied whether the GSK3B-insomnia association may fit into the larger picture of mood disorders.
       
  • Analysis of voxel-mirrored homotopic connectivity in medication-free,
           current major depressive disorder
    • Abstract: Publication date: Available online 24 July 2018Source: Journal of Affective DisordersAuthor(s): Huanhuan Fan, Xiao Yang, Jian Zhang, Yayun Chen, Tao Li, Xiaohong MaAbstractBackground: Recent neuroimaging studies suggest that abnormal function connectivity exists in patients with major depressive disorder (MDD). The aim of this study was to further analyze the underlying neural mechanism of MDD and explore whether clinical characteristics are correlated with the alerted homotopic connectivity in patients with MDD.Methods: Using voxel-mirrored homotopic connectivity (VMHC) during resting state, we compared 80 medication-free patients having current episodes of MDD and 124 never-depressed healthy controls (HCs) matched for age and gender.Results: We found decreased VMHC in patients with MDD in bilateral posterior cingulate cortex (PCC) extending to precuneus (Pre) compared with the HCs, which provided strong support for the potential role of PCC/Pre in recognizing interhemispheric connectivity deficits of MDD. Negative correlation between illness course and VMHC in PCC was observed as well.Limitations: First, we just compared the functional connectivity at a rest state but not under a specific task. Second, we did not mitigate the delayed effect on the measurable alterations in homotopic brain activity. Third, we did not make a longitudinal comparison after patients receiving therapeutic drugs.Conclusions: These findings that linking illness course with functional brain changes in depression help us understand the neural architecture of MDD.
       
  • Past depressive experiences do relate to suicidal ideation even when
           controlling for current depressive symptoms
    • Abstract: Publication date: Available online 24 July 2018Source: Journal of Affective DisordersAuthor(s): Rui C. Campos, Ronald R. Holden
       
  • The prospective relationship between postpartum PTSD and child sleep: A
           2-year follow-up study.
    • Abstract: Publication date: Available online 24 July 2018Source: Journal of Affective DisordersAuthor(s): Susan Garthus-Niegel, Antje Horsch, Myriam Bickle Graz, Julia Martini, Tilmann von Soest, Kerstin Weidner, Malin Eberhard-GranAbstractBackground: The main aim of this study was to examine the prospective impact of maternal postpartum PTSD on several standardized child sleep variables two years postpartum in a large, population-based cohort of mothers. Moreover, we investigated the influence of numerous potential confounding maternal and child factors. Finally, we tested potential reverse temporal associations between child sleep eight weeks postpartum and maternal PTSD symptoms two years postpartum.Methods: This study is part of the population-based Akershus Birth Cohort, a prospective cohort study at Akershus University Hospital, Norway. Data from the hospital's birth record, from questionnaires at 17 weeks gestation, eight weeks and two years postpartum were used. At two years postpartum, 39% of the original participants could be retained, resulting in a study population of n=1,480. All child sleep variables significantly correlated with postpartum PTSD symptoms were entered into multiple linear regression analyses, adjusting for confounding factors.Results: Postpartum PTSD symptoms were related to all child sleep variables, except daytime sleep duration. When all significant confounding factors were included into multivariate regression analyses, postpartum PTSD symptoms remained a significant predictor for number and duration of night wakings (β = 0.10 and β = 0.08, respectively), duration of settling time (β = 0.10), and maternal rating of their child's sleep problems (β = 0.12, all p < .01. Child sleep at eight weeks postpartum was not significantly related to maternal sleep two years postpartum when controlling for postpartum PTSD at eight weeks.Limitations: Child outcomes were based on maternal reporting and might be influenced by maternal mental health.Conclusions: Our results showed for the first time that maternal postpartum PTSD symptoms were prospectively associated with less favorable child sleep, thus increasing the risk of developmental or behavioral problems through an indirect, but treatable pathway. Early detection and treatment of maternal postpartum PTSD may prevent or improve sleep problems and long-term child development.
       
  • The relationship between cognitive and social functioning in older
           patients with bipolar disorder.✰
    • Abstract: Publication date: Available online 24 July 2018Source: Journal of Affective DisordersAuthor(s): Melis Orhan, Nicole Korten, Max Stek, Hannie Comijs, Sigfried Schouws, Annemiek DolsAbstractObjectives: Patients with bipolar disorder (BD) show specific cognitive impairments, especially in the domains of attention, executive functioning and memory. Social and occupational problems seem to exist in 30-60% of BD patients. This study analysed the relationship between cognitive and social functioning in older age BD (OABD) patients.Methods: This study included 63 OABD patients (aged>60). Cognitive functioning was measured by an extensive neuropsychological assessment including global cognitive functioning, attention, learning and memory, executive functioning and verbal fluency. Social functioning, was obtained by clinical interview, including global social functioning, meaningful contacts and social participation. Linear regression analyses were conducted between cognitive performance and social functioning and the role of depression severity and disease duration was explored.Results: Global social functioning, number of meaningful contacts and social participation were not interrelated. Global cognitive functioning, learning and memory and executive functioning were positively associated with global social functioning. No associations were found between cognitive functioning and social participation or meaningful contacts. Depression severity and disease duration were no effect modifiers.Limitations: Limitations include the use of a sample with relatively low cognitive and social impairments and the use of a cross-sectional research design.Conclusions: Global social functioning judged by the clinician was found to be independent of social functioning defined by the number of social contacts and social participation as reported by the patient. Global social functioning was related to cognitive functioning. An integrative treatment intervention including cognitive training and addressing social functioning may improve daily functioning in OABD patients.
       
  • MicroRNAs in Depression and Suicide: Recent Insights and Future
           Perspectives
    • Abstract: Publication date: Available online 24 July 2018Source: Journal of Affective DisordersAuthor(s): Yogesh DwivediAbstractSuicide is a major public health concern. A significant proportion of depressed individuals show suicidal ideation. The currently available medications are not optimal and a large number of depressed/suicidal patients do not respond to these medications. Thus, there is an urgent need to fully understand the neurobiological mechanisms associated with depression and suicidal behavior and to find novel targets for therapeutic interventions. In this regard, microRNAs (miRNAs), member of small non-coding RNA family, have emerged as an invaluable tool not only to understand disease pathogenesis but also to precisely pinpoint the targets that can be developed as drugs. In this review, these aspects have been discussed in a comprehensive and critical manner.
       
  • Problematic eating behaviours, changes in appetite, and weight gain in
           Major Depressive Disorder: The role of leptin
    • Abstract: Publication date: Available online 24 July 2018Source: Journal of Affective DisordersAuthor(s): Jessica G. Mills, Susan J. Thomas, Theresa A. Larkin, Nagesh B. Pai, Chao DengAbstractBackgroundAppetite and weight changes are core symptoms of Major Depressive Disorder (MDD), and those with MDD are at increased risk of obesity, cardiovascular disease and metabolic disorders. Leptin promotes satiety, with leptin dysregulation and resistance noted in obesity. However, the role of leptin in weight changes in MDD is not established. This study investigates leptin levels in relation to appetite and weight changes and problematic eating behaviours in MDD.MethodsPlasma leptin levels, psychopathology and biometrics were compared between participants meeting DSM-5 diagnostic criteria for MDD (n = 63) and healthy controls (n = 60). Depressed participants were also sub-categorised according to increased, decreased or unchanged appetite and weight. The Dutch Eating Behaviour Questionnaire and Yale Food Addiction Scale were examined in a subset of participants with MDD.ResultsFemales with increased appetite/weight had higher leptin levels than those with stable or reduced appetite/weight, however males showed the opposite effect. Leptin levels were positively correlated with problematic eating behaviours. One quarter of the depressed subset, all females, met the Yale criteria for food addiction, approximately double the rates reported in general community samples.LimitationsThe study is limited by a cross sectional design and a small sample size in the subset analysis of eating behaviours.ConclusionsThe results provide new information about associations between leptin, sex-specific weight and appetite changes and problematic eating behaviours, which may be risk factors for cardiovascular and metabolic diseases in MDD, particularly in females. Future longitudinal research investigating leptin as a risk factor for weight gain in MDD is warranted, and may lead to early interventions aimed at preventing weight gain in at-risk individuals.
       
  • Course and naturalistic treatment seeking among persons with first episode
           mania in India: A retrospective chart review with up to five years
           follow-up
    • Abstract: Publication date: Available online 24 July 2018Source: Journal of Affective DisordersAuthor(s): Karishma R. Kulkarni, Preethi V. Reddy, Abhishek Purty, Shyam Sundar Arumugham, Kesavan Muralidharan, YC Janardhan Reddy, Lakshmi Yatham, Sanjeev JainAbstractBackgroundAn understanding of the early course of Bipolar Disorder (BD) can contribute towards developing timely interventions. First episode mania (FEM) determines a diagnosis of bipolarity, and therefore, onset of BD-I. We investigated the course of BD-I over a five-year period after FEM by retrospective chart review.MethodsCharts of patients diagnosed with FEM in 2008 (n = 108) were reviewed. Data was extracted about FEM and subsequent course up to 5 years, for those who came for follow-up during this period. The factors influencing course were evaluated with statistical analyses including logistic regression and survival analysis.ResultsThe mean age at onset of BD was 26±9.2 years and mean age at FEM was 27.1± 9 years. 41 (38%) patients had previous depression. Patients who returned for at least one follow-up were 60/108 (55.6%), with 54 (90%) of them experiencing another mood episode following FEM. Most recurrences occurred between 6 months to 1 year after FEM, with manic episodes occurring two-three times as frequently as depressive episodes. Good adherence to treatment was a predictor of fewer hospitalizations. [B = -0.61; t = -3.1; p=0.004].LimitationsThe study was limited by its retrospective design and high number of dropouts.ConclusionThe five-year course after FEM showed twice the number of manic compared to depressive recurrences, irrespective of when the recurrence occurred. Consistent with earlier reports from India, BD-I appears to be mania-predominant, even early in the course. This has significant implications in planning maintenance treatments.
       
  • The Association Between Body Mass Index and Postpartum Depression: A
           Population-Based Study
    • Abstract: Publication date: Available online 24 July 2018Source: Journal of Affective DisordersAuthor(s): Michael E. Silverman, Lauren Smith, Paul Lichtenstein, Abraham Reichenberg, Sven SandinABSTRACTBackgroundPostpartum depression (PPD) reportedly affects between 6.5%-19% of all new mothers. Identifying those at greatest risk for PPD has implications for prevention, early detection and intervention. While the relationship between extremes of body mass index (BMI) and depression has been frequently studied, the association between BMI and PPD is less understood.MethodsProspective cohort of all women with live singleton births in Sweden 1997-2008. We calculated the relative risk (RR) for PPD in relation to each woman's BMI and depression history. PPD diagnosis was based on a clinical diagnosis of depression within the first postpartum year.ResultsFirst trimester BMI measurements were available for 611,506 women. Low BMI (35) RRadj=1.23, [95% CI:1.04-1.45] were associated with increased PPD risk. Women with a depression history had an increased risk with low BMI (RRadj=1.51, [95% CI:1.17-1.95]).LimitationsOnly first births were analyzed, potentially underestimating PPD incidence. Clinical data from health registries offers limited resolution regarding the specificity of diagnoses and incomplete sensitivity if women do not seek care.ConclusionsFirst trimester of pregnancy BMI is associated with PPD risk. This risk is further modified by depression history. While low BMI places all women at risk for PPD, being overweight increases risk of PPD only in women without a history of depression. Future research should explore potentially modifiable mechanisms involved in the relationship between PPD and BMI and should also examine interventional strategies for pregnant women at the extremes of BMI and/or with a depression history.
       
  • Prevalence of postpartum depressive symptoms in a multiethnic population
           and the role of ethnicity and integration
    • Abstract: Publication date: Available online 24 July 2018Source: Journal of Affective DisordersAuthor(s): Nilam Shakeel, Line Sletner, Ragnhild Sørum Falk, Kari Slinning, Egil W Martinsen, Anne Karen Jenum, Malin Eberhard-GranAbstractBackgroundPostpartum depression (PPD) may have adverse effects on both mother and child. The aims were to determine the prevalence of postpartum depressive symptoms, PPDS, identify associations with ethnicity and with the level of social integration.MethodPopulation-based, prospective cohort study of 643 pregnant women (58 % ethnic minorities) attending primary antenatal care in Oslo. Questionnaires regarding demographics and health issues were collected through interviews. PPDS was defined as a sum score ≥10 by the Edinburgh Postnatal Depression Scale, used as the main outcome in logistic regression analyses, first with ethnicity, second with level of integration as main explanatory factors.ResultsThe prevalence of PPDS was higher in ethnic minorities 12.7% (95 % CI: 9.31-16.09) than in Western Europeans 4.8 % (2.26-7.34). Adverse life events, lack of social support and depressive symptoms during the index pregnancy were other significant risk factors. Western European with PPDS were more likely to have had depressive symptoms also during pregnancy than women from ethnic minorities (72.2% versus 33.3 %, p=0.041). When replacing ethnicity with integration, a low level of integration was independently associated with PPDS (2.1 (1.11-3.95)).LimitationsCases with PPDS were limited. Heterogeneity in the ethnic groups is a concern.ConclusionBoth point prevalence and new onset of PPDS was higher among ethnic minorities than among Western Europeans. Low level of integration was associated with PPDS. Our findings suggest that clinicians should be aware of the increased risk of new cases of PPDS among ethnic minorities compared to Western European women and offer evidence-based care accordingly.
       
  • Alternate Day dTMS combined with SSRIs For Chronic Treatment Resistant
           Depression: A Prospective Multicenter Study
    • Abstract: Publication date: Available online 23 July 2018Source: Journal of Affective DisordersAuthor(s): Aron Tendler, Roman Gersner, Yiftach Roth, Abraham ZangenAbstractIntroductionChronic treatment resistant depression takes a substantial toll on patients' quality of life and alternative treatment options are limited. This prospective multicenter study evaluated the safety, tolerability and efficacy of four weeks of thrice-a-week deep transcranial magnetic stimulation (dTMS) in combination with selective serotonin reuptake inhibitors (SSRIs).MethodsForty patients who failed to respond during a 16-week double-blind placebo controlled (DBPC) trial of dTMS or sham dTMS as monotherapy were screened and started a treatment of previously tolerable but ineffective SSRI. After ten days of medication, high frequency dTMS was added three times a week for four weeks.ResultsdTMS combined with SSRIs was well tolerated, with only headaches as a related adverse event (n=4), which did not cause drop outs. Six patients were excluded from analysis: 1 was missing screening data and 5 received less than 10 sessions. Out of 34 patients included in this study, 12 (35.3%) patients remitted (HDRS-21
       
  • Sensory profiles in unipolar and bipolar affective disorders: possible
           predictors of response to antidepressant medications' A prospective
           follow-up study
    • Abstract: Publication date: Available online 23 July 2018Source: Journal of Affective DisordersAuthor(s): Batya Engel-Yeger, Boaz Bloch, Xenia Gonda, Giovanna Canepa, Maurizio Pompili, Leo Sher, Zoltan Rihmer, Mario Amore, Gianluca SerafiniAbstractIntroduction: Sensory processing patterns have been proposed as a stable dimension able to characterize individuals with major affective disorders, but to what extent specific impairments in sensory processing may be involved in the pathophysiology of these conditions is poorly understood. We aimed to explore which sensory profiles may better respond to psychoactive medications, with particular regard to antidepressants, according to depression, alexithymia, and hopelessness levels.Methods: A total of 402 outpatients who received maintenance treatment and were in stable psychopathological conditions were recruited and completed the Adolescent/Adult Sensory Profile (AASP), Toronto Alexithymia Scale (TAS-20), second version of the Beck Depression Inventory (BDI-II), and Beck Hopelessness Scale (BHS) according to a longitudinal prospective study design including three time points of measurements.Results: Subjects with abnormally reduced sensory seeking, hypersensitivity, enhanced sensory avoidance, and lower ability to register information better responded to antidepressant medications according to their reduced depression levels. Similarly, participants with lower registration better responded to antidepressants as reported by lower hopelessness levels. Regression analyses revealed that the use of antidepressants was the first variable able to predict depression, hopelessness, and alexithymia levels at baseline, and after three and six months of treatment, respectively, but the pattern of sensory sensitivity contribute to the prediction of depression and hopelessness. This pattern together with low registration predicted changes in alexithymia levels.Limitations: The study was limited by the small sample size at the follow-up assessment points.Discussion: Exploring sensory processing patterns may provide intriguing insights into specific illness characteristics and treatment response.
       
  • Stigma related to targeted school-based mental health interventions: A
           systematic review of qualitative evidence
    • Abstract: Publication date: November 2018Source: Journal of Affective Disorders, Volume 240Author(s): Petra C. Gronholm, Elizabeth Nye, Daniel MichelsonAbstractBackgroundSchool-based mental health services have been advocated to increase access to psychological support for children and adolescents. However, concerns have been raised about the potential stigma associated with selection of students and the visibility of school-based service contact.MethodsThis review assessed findings from qualitative studies to identify potential stigmatising effects of participation in targeted school-based mental health interventions for students attending primary- or secondary-level education. Eight articles (reflecting seven studies) were identified through electronic database searches (PsycInfo, EMBASE, Medline, CINAHL, ERIC), supplemented by citation and reference searches and expert consultations. Data were synthesised according to established guidelines for thematic synthesis.ResultsThree overarching themes were identified: “anticipated and experienced stigma”, “consequences of stigma” and “mitigating strategies”. These findings illustrate how pervasively stigma can compromise efforts to increase access to mental health care through targeted school-based provision, while also outlining strategies endorsed by students for alleviating the risk and/or impact of stigma.LimitationsThe findings need to be considered in view of the relative scarcity of surveyed evidence. Furthermore, as all evidence came from high-income and Western countries, the applicability to other contexts is unclear.ConclusionsThis synthesis reflects the first overview of qualitative evidence regarding stigmatising experiences and concerns associated with students’ engagement with targeted school-based mental health interventions. The findings should inform efforts for mitigating stigma-related barriers to students’ engagement in targeted mental health support, and serve to guide future research in this area.
       
  • Further development and testing of the metacognitive model of
           procrastination: Self-reported academic performance
    • Abstract: Publication date: November 2018Source: Journal of Affective Disorders, Volume 240Author(s): Bruce A. Fernie, Umran Y. Kopar, Peter L. Fisher, Marcantonio M. SpadaAbstractBackground: procrastination is highly prevalent amongst students and impairs academic performance. The metacognitive model of procrastination explains a significant proportion of unintentional procrastination variance. However, the model has yet to be tested using academic performance as the dependent variable. We tested whether the metacognitive model of procrastination explained self-reported academic performance (AP). Methods: a convenience sample of 204 current undergraduate and postgraduate students completed a battery of online questionnaires that measured intentional and unintentional procrastination, metacognitions about procrastination, AP, and depression. We conducted a series of correlation analyses and a path analysis (based on the metacognitive model of procrastination) that specified AP as the dependent variable. Results: the correlation analyses indicated that there are significant, negative associations between AP and depression, AP and negative metacognitions about procrastination, and AP and unintentional procrastination. The tested model was a good fit of the data and explained 13% of the variance in AP. Limitations: this study is cross-sectional. Conclusions: our findings provide further support for the metacognitive model of procrastination, indicating that novel interventions that target metacognitions may help to tackle procrastination and optimize AP.
       
  • Poor evidence for putative abnormalities in cerebrospinal fluid
           neurotransmitters in patients with depression versus healthy
           non-psychiatric individuals: A systematic review and meta-analyses of 23
           studies
    • Abstract: Publication date: November 2018Source: Journal of Affective Disorders, Volume 240Author(s): Josefine Pech, Julie Forman, Lars Vedel Kessing, Ulla KnorrAbstractBackgroundAlthough investigated for decades, surprisingly no systematic review has ever been published on monoamines concentrations in cerebrospinal fluid (CSF) in major depressive disorder (MDD) versus healthy individuals (HC).MethodsWe did a systematic review and meta-analyses according to the PRISMA Statement based on comprehensive database searches for studies on CSF biomarkers of monoamines and their precursor and/or metabolites, and glutamine, glutamate and GABA in MDD versus HC. Risk of bias was systematically assessed.ResultsA total of 23 studies were included. Statistically significantly decreased levels between MDD and HC were found regarding CSF 5-HIAA (n = 2/13 (15%)), HVA (n = 2/11 (18%)), MHPG (n = 1/8 (13%)), and GABA (n = 2/4 (50%)), while increased levels were reported regarding NE (n = 1/2 (50%)), MHPG (n = 1/8 (13%)) and DOPEG (n = 1/1 (100%)). A majority of the studies found no statistically significant differences between MDD and HC regarding CSF 5-HIAA, HVA, NE, MHPG, glutamine, glutamate and GABA. Meta-analyses showed: 5-HIAA (−3.85, −8.89, 1.19, 0.14), HVA (−18.02, −30.99, −5.04, 0.01), MHPG (0.11, −2.96, 3.17, 0.95) and GABA (−33.20, −51.79, −14.62, 0.00) (mean difference, lower 95% CL, upper 95% CL, p-value). Most studies were influenced by risk of bias mainly due to small sample sizes, and not considering potential confounders as age, gender, severity of depression, body height and position during lumbar puncture, analytics of biomarkers and medication.ConclusionThe evidence for CSF 5-HIAA, HVA, NE, MHPG, DOPEG and GABA being related to the pathophysiology of MDD is poor. Future controlled studies of monoamines or metabolites should validate the null i.e., that the concentrations of these compounds are not abnormal in MDD.
       
  • Treatment of Acute Stress Disorder for Victims of Violent Crime
    • Abstract: Publication date: Available online 20 July 2018Source: Journal of Affective DisordersAuthor(s): Stéphane Guay, Josette Sader, Richard Boyer, André MarchandAbstractBackgroundVictims of violent crime are at elevated risk of developing acute stress disorder (ASD) as well as subsequent post-traumatic stress disorder (PTSD), both of which are linked to severe psychological distress. The aim of this 12-month prospective study was to evaluate the efficacy of cognitive-behavioral therapy (CBT) vs. cognitive-behavioral therapy with a significant other (CBT-SO), relative to usual care (UC), for the improvement of post-traumatic, depression and anxiety symptoms and the prevention of PTSD among victims of violent crime with ASD.MethodsA total of 166 victims of violent crime with ASD were assigned to CBT (n=54), CBT-SO (n=52) or UC (n=60). Self-report assessments and diagnostic interviews were completed at pre-treatment and post-treatment as well as at 6-month and 12-month follow-ups.ResultsCBT and CBT-SO participants had fewer depression symptoms than those in the UC group up to 12 months post-event. Significantly fewer participants in the CBT condition met criteria for PTSD than in the UC group up to 12 months post-event. The CBT group did not differ from the CBT-SO group on any variable at any assessment time.LimitationsFindings must be interpreted in light of the quasi-experimental nature of the study and limitations concerning the management of missing data.ConclusionsFurther research is warranted in order to assess whether more extensive involvement of a significant other in therapy may lead to better outcomes for victims of violent crime with ASD.
       
  • Anxiety in Parkinson's disease is associated with reduced structural
           covariance of the striatum
    • Abstract: Publication date: Available online 20 July 2018Source: Journal of Affective DisordersAuthor(s): Caroline S. Oosterwijk, Chris Vriend, Henk W. Berendse, Ysbrand D. van der Werf, Odile A. van den HeuvelAbstractBackground: anxiety is highly prevalent in Parkinson's disease (PD) and has great negative impact on quality of life. Functional and structural neuroimaging studies have contributed to our understanding of the symptomatology of PD but still little is known about the pathophysiology of PD-related anxiety.Methods: we used seed-based structural covariance analysis to study the anatomical network correlates of anxiety in PD. Structural covariance analysis is based on the statistical correlation between regional brain volumes measured on T1-weighted magnetic resonance images. We investigated the association between anxiety symptoms, as measured by the Beck Anxiety Inventory (BAI), and seed-to-whole-brain structural covariance networks in 115 patients with idiopathic PD using five bilateral seeds: basolateral amygdala, centromedial-superficial amygdala, dorsal caudate nucleus, dorsal-caudal putamen, and nucleus accumbens. Results - severity of anxiety correlated negatively with structural covariance between the left striatal sub-regions and the contralateral caudate nucleus. Moreover, severity of anxiety was associated with reduced structural covariance between the right dorsal caudate nucleus and ipsilateral ventrolateral prefrontal cortex and between the left nucleus accumbens and ipsilateral dorsolateral prefrontal cortex. Structural covariance of the amygdalar seeds did not correlate with anxiety.Conclusions: we interpret these findings as a reduced interhemispheric cooperation between the left and right striatum and reduced prefrontal-striatal connectivity, possibly related to impaired ‘top-down’ regulation of emotions. These findings shed more light on the pathophysiology of PD-related anxietyLimitations: This study did not include PD patients with an anxiety disorder.
       
  • Depressive Symptom Trajectories and Physical Health: Persistence of
           Problems from Adolescence to Young Adulthood
    • Abstract: Publication date: Available online 20 July 2018Source: Journal of Affective DisordersAuthor(s): Megan E. Ames, Bonnie J. LeadbeaterAbstractBackgroundWe examine how depressive symptom trajectories are related to adolescent and young adult subjective health, health-promoting, health-risk, and sexual risk behaviors, as well as cardiometabolic risks.MethodData came from a community-based sample of youth (N = 662; 52% female) followed biannually, six times across 10 years. Latent class growth analysis identified four depressive symptom trajectories which were compared on adolescent (T1; ages 12 to 18) and young adult (T6; ages 22 to 29) health indicators.ResultsThe Low stable trajectory (49%) showed the fewest health risks. The Persistent high trajectory (9%) reported higher physical symptoms, lower physical self-concept, less physical activity and sleep, and higher rates of smoking and sexual risk behaviors than the Low stable trajectory and risks for physical symptoms, physical self-concept, and physical activity worsened in young adulthood. Increasers (21%) showed risks for physical symptoms, physical activity, and sleep in adolescence and problems for physical symptoms and physical self-concept persisted in young adulthood. Decreasers (22%) showed risks for physical symptoms, physical self-concept, physical activity, and sleep in adolescence but these risks resolved into young adulthood.LimitationsFindings may not generalize to ethnic minorities. Sex differences were not examined due to sample size limitations and most variables, except cardiometabolic risks, were self-reported.ConclusionsFindings suggest early treatment of depressive symptoms that includes strategies addressing physical symptoms, physical self-concept, and physical activity may prove beneficial. Screening youth for physical symptoms and declines in health-promoting behaviors may also identify youth at risk of depression onset and progression.
       
  • Clinical Utility of the 15-Item Geriatric Depression Scale (GDS-15) for
           Use with Young and Middle-aged Adults
    • Abstract: Publication date: Available online 20 July 2018Source: Journal of Affective DisordersAuthor(s): Julia M. Guerin, Marc L. Copersino, David J. SchretlenAbstractBackgroundThe Geriatric Depression Scale, Short Form (GDS-15) is a widely-used depression rating scale for elderly adults. It might be useful for persons across the adult lifespan, but more research is needed to support its clinical utility with young and middle-aged adults.MethodsWe examined the classification accuracy of the GDS-15 in identifying depression cases and non-cases in adults aged 18 to 54 (n = 199) compared to those aged 55 to 80 (n = 112), using the standard cutoff score of 5. Criterion-related validity of the GDS-15 was examined based on its chance-corrected agreement with a clinical diagnostic interview.ResultsClassification accuracy based on receiver operating characteristic (ROC) analysis was strong in younger (area under the curve; AUC = 0.92) and older adults (AUC = 0.94). Sensitivity and specificity of the GDS-15 for identifying depression were 72% and 97% for younger adults and 86% and 91% for older adults, respectively. Classification accuracy did not differ between age cohorts (z = 0.74, p = 0.46). Chance-corrected agreement (kappa) between the GDS-15 and the criterion was 71% for younger and 74% for older adults.LimitationsAnalyses are based on a convenience sample aggregated from three community mental health studies. Minor procedural inconsistencies may be present. Group sizes were uneven and accentuated cell size differences in the confusion matrices.ConclusionsThe GDS-15 is brief depression rating scale that shows good diagnostic sensitivity and specificity for adults aged 18 and older.
       
  • Deficits of perceived spatial separation-induced prepulse inhibition in
           patients with bipolar disorder compared to healthy controls
    • Abstract: Publication date: Available online 19 July 2018Source: Journal of Affective DisordersAuthor(s): Qijing Bo, Zhen Mao, Qing Tian, Yujie Wen, Fang Dong, Xianbin Li, Zhimin Wang, Xin Ma, Chuanyue WangABSTRACTObjectiveThis study aimed to assess sensorimotor gating deficits in patients with bipolar disorder (BD) using a modified perceived spatial separation-induced prepulse inhibition (PSS-PPI) paradigm. The relationships between PSS-PPI, demographic and clinical characteristics, and cognitive functioning were also analyzed.MethodsIn this cross-sectional study, 30 patients with BD were compared to 33 healthy controls (HC) with respect to prepulse inhibition measures of PSS-PPI using a 120 ms lead interval. The Young Mania Rating Scale, Hamilton Depression Scale, and Hamilton Anxiety Scale were used to assess manic, depressive, and anxiety symptoms. Cognition was evaluated using the Repeatable Battery for the Assessment of Neuropsychological Status (RBANS) and the Stroop color-word test.ResultsCompared with HC, patients with BD had a lower PSS-PPI level. PSS-PPI showed medium effect size (ES) between patients with BD and HC (ES = 0.65). Among patients with BD, PSS-PPI was positively correlated with the language domain of RBANS and negatively correlated with double word time and color interference time. There were no differences in PSS-PPI levels between patients with and without psychotic symptoms or between those euthymic patients or depressive patients with BD.ConclusionsPatients with BD show a sensorimotor gating deficit as measured by perceived spatial separation-induced PPI of the startle response, which was more sensitive compared to the classic PPI paradigm. Euthymic bipolar patients and depressive bipolar patients show similar PPI level. PPI deficit in patients with BD is related to cognition, but not with demographic and clinical characteristics.
       
  • An exploratory examination of reappraisal success in depressed
           adolescents: preliminary evidence of functional differences in cognitive
           control brain regions
    • Abstract: Publication date: Available online 19 July 2018Source: Journal of Affective DisordersAuthor(s): Kaja Z. LeWinn, Irina A. Strigo, Colm G. Connolly, Tiffany C. Ho, Olga Tymofiyeva, Matthew D. Sacchet, Helen Y. Weng, Eva Henje Blom, Alan N. Simmons, Tony T. YangABSTRACTBackgroundMost neuroimaging studies of adolescent depression employ tasks not designed to engage brain regions necessary for the cognitive control of emotion, which is central to many behavioral therapies for depression. Depressed adults demonstrate less effective activation of these regions and greater amygdala activation during cognitive reappraisal; we examined whether depressed adolescents show similar patterns of brain activation.MethodsWe collected functional magnetic resonance imaging (fMRI) data during cognitive reappraisal in 41 adolescents with major depressive disorder (MDD) and 34 matched controls (ages 13–17). We examined group differences in 1) activations associated with reappraisal and reappraisal success (i.e., negative affect reduction during reappraisal) using whole brain and amygdala region-of-interest analyses, and 2) functional connectivity of regions from the group-by-reappraisal success interaction.ResultsWe found no significant group differences in whole brain or amygdala analyses during reappraisal. In the group-by-reappraisal success interaction, activations in the left dorsomedial prefrontal cortex (dmPFC) and left dorsolateral PFC (dlPFC) were associated with reappraisal success in healthy controls but not depressed adolescents. Depressed adolescents demonstrated reduced connectivity between the left dmPFC and the anterior insula/inferior frontal gyri bilaterally (AI/IFG) and between left dlPFC and left AI/IFG.LimitationsOur results should be considered exploratory given our less conservative statistical threshold in the group-by-reappraisal interaction.ConclusionsWe find preliminary evidence that depressed adolescents engage cognitive control regions less efficiently than healthy controls, suggesting delayed maturation of regulatory prefrontal cortex regions; more research is needed to determine whether cognitive therapies improve functioning of these regions in depressed youth.
       
  • Increased sensitivity to sad faces in depressive symptomatology: A
           longitudinal study
    • Abstract: Publication date: Available online 19 July 2018Source: Journal of Affective DisordersAuthor(s): Anna Nakamura, Ryu Takizawa, Haruhiko ShimoyamaAbstractBackgroundNegative bias to sad emotional stimuli has repeatedly been identified as a cognitive feature of major depressive disorder, particularly in facial expression recognition. However, it is unknown how negative bias applies to facial expression recognition in individuals with depressive symptoms.MethodsA total of 58 university students’ facial expression recognition and depression scores were measured using facial stimuli displaying the whole face, with 39 participants completing a 3-month follow-up assessment of depressive symptoms. We used an index that differentiates sensitivity to sadness from sensitivity to general facial expressions. Participants gave written informed consent after a complete description of the study.ResultsThe group with higher depressive symptoms showed a higher sensitivity to sadness than those with lower depressive symptoms, indicating a relationship between negative bias in facial expression recognition and nonclinical depressive symptoms. From a longitudinal point of view, negative bias to sad expressions at one time point was found to predict the change in depression scores at the 3-month follow-up.LimitationsSince the participants included only college students, the generalizability of our results to other populations is limited. The three-month interval may not be sufficient to determine the prognosis of depression, suggesting the need for further replications.DiscussionThis study was the first to report the negative bias of facial expression recognition in individuals with nonclinical depressive symptoms. Given that negative bias predicts present and future depression, facial expression recognition has the potential to be used as a screening tool for early detection of depression.
       
  • A reliable global cognitive decline and cortisol as an associated risk
           factor for patients with late-life depression in the short term: a 1-year
           prospective study
    • Abstract: Publication date: Available online 19 July 2018Source: Journal of Affective DisordersAuthor(s): Xiaomei Zhong, Yuping Ning, Yong Gu, Zhangying Wu, Cong Ouyang, Wanyuan Liang, Ben Chen, Qi Peng, Naikeng Mai, Yuejie Wu, Xinru Chen, Xingbing Huang, Suyue PanAbstractBackgroundLate-life depression is a risk factor of dementia. It may increase the risk of reliable cognitive decline in the short term, and its associated risk factors remain unclear. Cortisol levels may be one of the important predictors.ObjectivesTo estimate whether patients with late-life depression are at an increased risk for reliable global cognitive declines in 1 year, and explore associated risk factors predicting cognitive declines.MethodsThis prospective 1-year follow-up study involved 148 participants (67 with late-life depression and 81 normal elderly). Global cognitive functions were assessed by the Mini-Mental State Examination (MMSE). The reliable global cognitive decline was defined by the reliable change index (RCI) of the MMSE. Factors related to cognitive function (e.g., age, gender, education, duration of depression and severity of depression) were obtained. Serum cortisol levels were measured at baseline.ResultsAt the 1-year follow-up assessment, 19 patients with late-life depression (28.4%) showed reliable global cognitive declines, a risk that was 6.4 times (95% CIs = 1.3-31.1, p = 0.021) higher than that of normal elderly. Elevated serum cortisol levels and older age were associated with the risk of cognitive decline that was 1.6- and 1.2-times higher (95% CIs = 1.07-2.5, p = 0.02, and 95% CIs = 1.04-1.4, p = 0.01 respectively).LimitationsSerum cortisol levels were measured only in the morning.ConclusionsLate-life depression is associated with a greatly increased risk of reliable cognitive decline in short term. Cortisol dysregulation may contribute to the pathology of cognitive decline.
       
  • Salivary cortisol reveals overt and hidden anxiety in survivors of
           childhood cancer attending clinic
    • Abstract: Publication date: Available online 18 July 2018Source: Journal of Affective DisordersAuthor(s): Mazen Amatoury, Ann M. Maguire, Jake Olivier, Belinda Barton, Melissa Gabriel, Luciano Dalla-Pozza, Katharine S. Steinbeck, Robert A. BattistiAbstractBackgroundSymptoms of anxiety may arise from fear of cancer recurrence and memories of traumatic experiences during treatment. This study aimed to identify changes in mental health and cortisol, a biological marker of stress, associated with oncology surveillance clinic attendance.MethodsAdolescent and young adult (AYA) survivors of childhood cancer (aged 12-30 years, N = 46) attending a survivorship clinic were recruited. The State-Trait Anxiety Inventory, an anxiety self-rating and open answer question, and salivary cortisol collections were completed two weeks before and one day before clinic, on clinic day and two weeks after.ResultsTrait anxiety scores were consistent with the normal population. State anxiety scores two weeks after clinic were significantly lower than baseline (p = 0.02). Cortisol diurnal slopes were flatter than baseline after clinic (p = 0.02). Evening cortisol levels were significantly higher than baseline two weeks post clinic (p = 0.02).LimitationsCombined results from biological and psychometric assessments can be difficult to interpret. Larger cohorts will further delineate cortisol pathway activity and distress in AYA cancer survivors.ConclusionsPsychometric evidence indicates that AYA survivors of childhood cancer perceive themselves to be less anxious after a survivorship clinic visit. Biological evidence, however, indicates a dysregulation of the hypothalamic-pituitary-adrenal axis which may be linked to clinic attendance. Weak correlations suggest that cortisol may not be a reliable indicator of self-perceived anxiety. This may be due to confounding lifestyle factors influencing the stress response or potential ‘coping strategies’ developed during past treatment experience which may, hypothetically, have masked self-perceived anxiety.
       
  • Evaluation of the factor structure, prevalence, and validity of disturbed
           grief in DSM-5 and ICD-11
    • Abstract: Publication date: Available online 18 July 2018Source: Journal of Affective DisordersAuthor(s): Paul A. Boelen, Lonneke I.M Lenferink, Angela Nickerson, Geert E. SmidAbstractBackgroundPersistent complex bereavement disorder (PCBD) is a disorder of grief included in DSM-5 Section 3. Prolonged Grief Disorder (PGD) is a disorder of grief that will enter the forthcoming ICD-11. This study evaluated the factor structure, prevalence, and validity of disturbed grief as per DSM-5 and ICD-11.MethodsWith data from a community sample (N=512), we used confirmatory factor analysis (CFA) to evaluate the fit of different factor models for PCBD and PGD, determined diagnostic rates for probable PCBD and PGD, and used sensitivity/specificity analyses to evaluate the performance of individual items as indicators of PCBD and PGD. We calculated associations of PCBD-caseness and PGD-caseness with concurrently assessed symptoms of posttraumatic stress disorder and depression and, in a subset of 280 participants, with these same symptoms assessed one year later, to examine concurrent and predictive validity of PCBD and PGD.ResultsFor PCBD-symptoms, a three-factor model with distinct factors of separation distress, reactive distress, and social/identity disruption fit the data well; for PGD-symptoms a two-factor model with distinct separation distress symptoms and additional symptom (e.g., guilt, anger, blame) yielded acceptable model fit. Overall, items evidenced strong sensitivity and negative predictive power, and relatively poor specificity and positive predictive power. The prevalence of probable DSM-5 PCBD (6.4%) was significantly lower than ICD-11 PGD (18.0%). Both PCBD and PGD were significantly associated with concurrent overall grief, depression, and PTSD; PCBD but not PGD was associated with symptoms one year beyond baseline.LimitationsLimitations include our reliance on self-reported data and symptoms of PCBD and PGD being derived from two scales.ConclusionsFindings provide preliminary evidence for the validity of both the PCBD and PGD constructs, albeit that prevalence rates of both constructs and predictive validity differ—which needs further scrutiny.
       
  • THRESHOLDS FOR SEVERITY, REMISSION AND RECOVERY USING THE FUNCTIONING
           ASSESSMENT SHORT TEST (FAST) IN BIPOLAR DISORDER
    • Abstract: Publication date: Available online 17 July 2018Source: Journal of Affective DisordersAuthor(s): C.M. Bonnín, A. Martínez-Arán, M. Reinares, M. Valentí, B. Solé, E. Jiménez, L. Montejo, E. Vieta, A.R. RosaAbstractBackground: Despite its importance, no distinction between none, mild, moderate and severe functional impairment is available. Categorization of functional impairment could help to better assess randomized controlled trials (RCT) and to study the correlates of functional impairment according to severity. The Functional Assessment Short Test (FAST) is one of the most widely used measures of functional impairment in bipolar disorder and related conditions, but to date no severity cut-offs have been determined for their use in clinical research and practice.Method: FAST and Global Functioning Assessment (GAF) ratings from 65 euthymic outpatients with bipolar disorder at the Hospital Clínic in Barcelona were analyzed. A linear regression was computed using the FAST as the independent variable and the GAF as the dependent variable. Cut-offs scores for the FAST were estimated taking into account the GAF scores as a reference.Results: Linear regression analysis with GAF scores as the dependent variable yielded the following equation: GAF score = 91,41-1,031 * FAST score. The cut-off scores for the FAST scale derived from this equation were as follows: scores from 0 to 11 included patients with no impairment. Scores from 12 to 20, represented the category of mild impairment. Moderate impairment comprised scores from 21 to 40. Finally, scores above 40 represent severe functional impairment. Further, the 4 × 4 cross-tabulation resulted in a significant association of FAST and GAF severity gradation: (Chi2=95,095; df=9; p
       
  • Gender-related patterns of psychiatric disorder clustering among bariatric
           surgery candidates: a latent class analysis
    • Abstract: Publication date: Available online 17 July 2018Source: Journal of Affective DisordersAuthor(s): Leorides Severo Duarte-Guerra, Bruno Mendonça Coêlho, Marco Aurélio Santo, Francisco Lotufo Neto, Yuan-Pang WangAbstractBackgroundPsychiatric disorders tend to distribute unevenly in women and men with severe obesity. The current research aimed to identify homogeneous clusters of concurrent psychiatric disorders among patients seeking bariatric surgery, by gender.MethodsWe recruited a consecutive sample of 393 candidates with obesity (311 women and 82 men) in a university-based bariatric center. Trained clinicians assessed psychiatric disorders through the Structured Clinical Interview for DSM-IV (SCID). Latent class analysis categorized pre-surgical patients into uniform clusters of co-occurring psychiatric disorders.ResultsFor both genders, the 3-class psychopathological clustering was the best-fitting solution. Among women, the latent classes were: (1) “oligosymptomatic”, wherein 42% of patients showed low probability of psychiatric disorders; (2) “bipolar with comorbidities”, in 33%; and (3) “anxiety/depression”, in 25%. Among men, (1) “bipolar with comorbidities” was found in 47% of patients; (2) “oligosymptomatic”, in 40%; and (3) “anxiety/depression”, in 13%. For both genders, the probability of presenting eating disorders was higher in both “bipolar” and “anxiety/depression” classes. Substance use disorders was prominent among “bipolar” men. In comparison with “oligosymptomatic” class, the likelihood of higher BMI was observed among “bipolar” men and poorer work attainment among men with “anxiety/depression”.LimitationParticipants was cross-sectionally drawn from a single bariatric center.ConclusionsPre-surgical men and women with severe obesity were distributed in three comorbidity profiles and revealed analogous psychopathological patterns. The class of “bipolar disorders” most likely presented comorbidity with eating and substance use disorder. This natural clustering of psychiatric disorders among bariatric patients suggests gender-related therapeutic approaches and surgical outcomes.
       
  • Neuron-Related Blood Inflammatory Markers as an Objective Evaluation Tool
           for Major Depressive Disorder: An Exploratory Pilot Case-Control Study
    • Abstract: Publication date: Available online 17 July 2018Source: Journal of Affective DisordersAuthor(s): Nobuki Kuwano, Takahiro A. Kato, Masato Mitsuhashi, Mina Sato-Kasai, Norihiro Shimokawa, Kohei Hayakawa, Masahiro Ohgidani, Noriaki Sagata, Hiroaki Kubo, Takeshi Sakurai, Shigenobu KanbaAbstractBackgroundNeuroinflammation is suggested to be a crucial factor in the pathophysiology of major depressive disorder (MDD). Analysis of neuron-derived exosomes (NDE) in peripheral blood has recently been highlighted to reveal the pathophysiology of brain diseases without using brain biopsy. Currently, human NDE studies require a considerable amount of peripheral blood to measure multiple substances inside exosomes. Previously, NDE-based clinical studies focusing on MDD have not been reported.MethodsAs an exploratory pilot case-control study between healthy controls (HC) and drug-free MDD patients (each; N = 34), we searched for NDE-related blood biomarkers with a small amount of peripheral blood using a novel sandwich immunoassay between anti-neuron antibody and antibodies against CD81 (an exosome marker) and against other proteins related to neuroinflammation and synaptic functions.ResultsMost neuron-related blood biomarkers had moderately to strongly positive correlation with CD81 (NDE), thus we normalized the above biomarkers by CD81 (quantity of each biomarker/CD81) to predict NDE-related blood substances. Interleukin 34 (IL34)/CD81 levels were significantly higher in MDD group compared to HC group. Synaptophysin (SYP), SYP/CD81, and tumor necrosis factor receptor 1 (TNFR1)/CD81 were positively correlated with severities of depression and/or various sub-symptoms.LimitationsWe did not actually extract NDE from peripheral blood.ConclusionsUsing a small amount of peripheral blood, we have successfully detected possible NDE-related blood biomarkers. This is the first study to suggest that not only SYP and TNFR1 but also IL34 are important blood biomarkers for patients with MDD. Further studies are warranted to evaluate the present study.
       
  • Medical and Non-Medical Marijuana Use in Depression: Longitudinal
           Associations with Suicidal Ideation, Everyday Functioning, and Psychiatry
           Service Utilization
    • Abstract: Publication date: Available online 17 July 2018Source: Journal of Affective DisordersAuthor(s): Amber L. Bahorik, Stacy A. Sterling, Cynthia I. Campbell, Constance Weisner, Danielle Ramo, Derek D. SatreAbstractBackgroundMarijuana use is clinically problematic in depression, and non-medical and medical use may both contribute to barriers to care in this population. Among outpatients with depression, we examined the differential impact of medical or non-medical marijuana use, relative to no-use, on psychopathology and service use over time.MethodParticipants were 307 psychiatry outpatients participating in a trial of drug/alcohol use treatment for depression. Measures of past 30-day marijuana use, depression/anxiety symptoms, psychiatry visits, and functional data related to health status were collected at baseline, 3, 6, and 12 months. Regressions (baseline and 1 year) and growth models (over time) predicted clinical and psychiatry visit outcomes, from medical or non-medical marijuana use (no-use=reference).ResultsAt baseline, 40.0% of the sample used marijuana and more reported non-medical (71.7%) than medical (28.2%) use. Relative to non-users at baseline, patients using medically had worse mental/physical health functioning (p's
       
 
 
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